I am crying and sad and afraid – watching yet more hate and fear-mongering thrown at trans children, specifically at girls like my daughter.

The BBC Victoria Derbyshire show (05/03/18) want a discussion on the Gender Recognition Act. An act that at present only applies to adults and only relates to birth certificates. Not, as they are discussing, access to changing rooms or toilets.

An act that bears zero relevance to the Girl Guides having a progressive policy of welcoming trans girls.

Yet the BBC gives air time to the worst type of bigotry – raising fear about the threat my young daughter poses if she goes on a camping trip with her friends. .

No wonder trans children are struggling in the UK RIGHT NOW

Take any other minority. Take Muslim children, or black children or Jewish children, or neuro diverse children.

Would the BBC give air time to a person saying that Jewish girls are a threat to other girls? Would they say that parents need to be made aware of any Muslim girls going on a camping trip?

Would they allow such hate to go unchallenged?

Why is it fine to throw my child under the bus time and time again?

And to have this dangerous, scary, legally and morally wrong rhetoric of trans children being a threat utterly unchallenged?

With two trans panellists who were clearly out of their comfort zone on the topic of trans girls like my daughter.

One trans panellist even seemed to agree, focusing on the importance of careful ‘trans’ risk assessments before camping trips for children.

My child is not a risk. She is not a threat. She does not need a risk assessment. She is not to be feared.

She would love to go camping with her friends. She is a child.

She’d love to stay up late and eat marshmallows and tell ghost stories and play and laugh

How dare the BBC present trans girls in girl guides as a safety concern?

How am I meant to keep my child safe when even the lovely Victoria Derbyshire gives space to this outrageous hate and fear-mongering?

How dare the panel nod and agree that this scare-mongering against vulnerable children is balanced?

I don’t blame Rebecca Root or Clara Barker both incredible women.

They did a better job than I could of at staying calm in the face of such prejudice.

They were brought on to talk about the Gender Recognition Act not to talk about trans children.

This is their standard approach. One of the panellists was even the public face of a website which explicitly states trans children are a ‘trend’ simultaneously denying their existence.

They do this because focusing on children is an easy win for those opposed to trans equality. They are defenceless.

They know that, like today, trans adults are often hesitant about speaking up for trans kids, possibly as the experience of socially transitioned trans kids today is outside of their direct experience.

They know that the UK public are totally ignorant about wonderful trans children like my daughter.

It is hard to stir up fear about trans women when sat opposite kind intelligent articulate trans women.

But without any young trans children on the show it is easy to spread fear about an unknown.

It’s easy to paint trans girls as a scary shadow.

The people who know trans children like my daughter see how preposterous this fear-mongering is.

She is just like any other girl.

But those raising anti-trans fear know that the public don’t know any trans girl guides.

They rely on this ignorance. They don’t care about the impact of this fear-mongering on my child.

Can you imagine being a 10 year old girl, happy to be moving up from Brownies to Girl Guides, excited to be going camping.

And watching the BBC describe you as a threat to your friends.

No wonder trans children are at breaking point in the UK.

The UK is not a safe place for my child and with every ‘debate’ which allows lies and misinformation to go unchallenged it becomes more dangerous.

How am I meant to tell my wonderful kind sweet (brave, clever, strong, funny) girl that everything is going to be alright when I just don’t have hope?

This country is a scary place to be a trans girl.

I am scared and I have had more than I can bear.

This is not balanced debate.

This is hate.

This is intent to incite fear and prejudice against a defenceless and vulnerable group of children and the BBC has once again provided the platform.

This is not ok.

This is never ok.

World. Be Better.

P.S. The photo is not my daughter. But is a wonderful trans girl (Rebekah) who deserves all the care and kindness and happiness the world can send. That girl’s mum (Jamie) blogs here

It’s 6am on a Saturday morning as I write this. I’ve been awake for hours, worried about the latest impact of a targeted campaign of hate directed at my child and those like her. Thinking about whether I can do anything to stem the tide.

I don’t have long.

Soon the kids will be tearing down the stairs, asking for TV, porridge, a game.

When the interruption comes, I’ll be glad of it.

I’ve been asked by Susie Green, CEO of Mermaids, to take a look at a document that has been put out by “Transgender Trend”, an organisation which claims to support parents who are questioning a ‘trend’ of children ‘identifying as transgender’.

This isn’t the first time I am left with my stomach in knots as I read lies and distortions about my child and our family. The idea that people spend so much time and energy making my daughter’s life harder, chipping away at the limited acceptance and support that she has, is frightening – I need to respond, I need to help her, she’s already faced so much.

The document, a Resource Pack for schools, is predictably awful in many ways. Outright lies, misinformation, fake news wrapped in a glossy veneer – the latest weapon of a long campaign aimed at making the lives of trans children impossible – painting them as mentally disturbed, as deluded, as a threat. It is so flawed it is hard to know where to begin. I’ve made a start, but having got to page five with pages of critique, the approach isn’t sustainable. Time is short.

How did I get here?

I’ve known Susie for years now. She was the volunteer who picked up the phone when I first contacted Mermaids looking for support.

I’d registered with Mermaids weeks before, and tried phoning several times, but, understaffed, and relying upon a small group of trained volunteers, the charity had taken a month to reach my application and phone to guide through their assurance process. Those weeks had been tough, my wife and I were at breaking point, worried, isolated, without support. The call from Susie was a life-line, reaching out through the dark. “Is now a good time, she asked?”.

It was evening, Susie had been working the late shift, and had pulled into a service station on her drive home to call. It wasn’t her usual time on the Mermaids rota, but after hearing several answer phone messages, and recognising a family in crisis, Susie had sacrificed her evening to come to our aid.

Over the next hour, glass of wine as crutch, my words rushed out. How our child, who we had presumed a boy, had been stating for years that they were a girl. How their happiness had disappeared, the joy gone from their eyes, how we had a deeply upset and depressed child who cried every night and was losing out on their carefree childhood. How we’d spoken to a psychologist, our GP, school staff – how we’d read every book and article we could find. We had found stories of other parents with children like ours, but had never spoken to anyone who understood what we were going through. We felt utterly alone. Searching online for support we’d come across medical definitions of gender dysphoria on the NHS website including links to Mermaids.

I told Susie how our child had been growing increasingly miserable in recent months and had told us that the one thing they wanted in the world was for us to call them a girl. How we had continued to reject her night after night, saying we loved her but we couldn’t take that step. Yet our child was fading before us. We had finally made the earth shattering decision (for us as parents) to say yes, we can call you girl.

The words fell over each other as I talked to Susie, trying to keep my voice steady whilst emotions churned inside. I spoke about how no one else understood what we were going through, how we faced judgement and disapproval, how we’d lost close friends who wouldn’t understand. Susie listened.

Susie told me about her experience, and her child, Jackie, who she had thought was a boy but who fought the world to be seen as a girl. Jackie and Susie had conquered prejudice, bullies, violence and the ultra-conservative UK medical system. It had been tough, but Jackie had come through, stronger and confident in her identity as a young woman.

“How is your child now,” Susie asked?

I took a gulp of wine, before speaking again,

I told Susie how since we had accepted our child as a girl, since we had stopped our nightly cycle of rejection and denial, the joy had come back into her life. How she had started talking about books and toys and animals again. How she had started to laugh and smile. How she had grown in confidence. How the stress and weight of the world on her shoulders had lifted. How a simple shift in pronoun had transformed our sad depressed child into one with the happiness of a child who has finally been seen by their parents.

We’ve had our share of challenges, all related to how the world treats children like my daughter. We’ve been on a huge learning curve, and our friends, family and school have learnt alongside us. Support at school was critical. Great leadership from the head teacher and a proactive zero tolerance approach to bullying, including misgendering, meant that the school adapted quickly, accepting our daughter completely. Our child is now loving school, learning, growing and enjoying spending time with her friends – who love and accept her as a girl, and as trans.

Our focus has shifted – trying to help build a society that is ready for our daughter. A world that will love and accept her as we do – a world where she doesn’t face prejudice, discrimination and hate. A world where she can read a newspaper without seeing trans people mocked, feared, treated as lesser.

My daughter is still my daughter. She is happy. Thriving. Her being transgender is the least interesting thing about her. She’s just a girl.

I’d like to say more but the children are awake, my time is up. I’ve been called to judge a Lego-making competition. The weekend awaits.

Transgender trend ‘School resource pack’ – A teacher’s perspective –

The writer has more than 12 years experience in teaching, including head of year in secondary and within a SEND setting.

As a teacher my first question is who has written this?

Who are the authors?

Usually on resources you see a whole load of signatories, accreditation and endorsing organisations. Here there’s nothing.

How am I meant to use it?

It is not a resource pack (it contains no specific resources) and I can see no practical application for it.

Looking at the linked website, ‘about us section’, the organisation claims to be founded by a group of parents who have created a website and twitter account but have no other stated organisation purpose or role which gives them legitimacy.

She mentions she founded a school and worked in various roles in the classroom and playground. This implies she is unqualified (if she was a trained teacher or head, or worked as governor, she would surely have mentioned that).

Reading more of her blurb it quickly links to a website full of naff stock photos and seems to be motivated to sell a book, which seems to be self-published.

Doing a cursory nose around the website’s FAQ section, the first FAQ they have chosen to address is very telling:

Aren’t you just transphobic?

No, we believe that transgender people deserve the same civil and human rights as all of us and should not face discrimination. As the term ‘phobic’ literally means ‘irrational fear’ we want to make it very clear that we are not afraid of, or prejudiced against, transgender people in any way.

Given the amount of prejudice content they are pedalling this answer is an immediate red flag.

It’s a bit like a organisation’s website (which is full of material that advocates racism) including a headline FAQ of : “Aren’t you racist?” Happily responding with – ‘No I’m not racist because racism actually means this’.

On to the publication in question

Despite being formatted like an official guidance document, the prejudice and agenda which came through from a brief look of the website are easy to spot.

The document starts by stating that it was developed in partnership with teachers and child welfare staff, again this is tellingly unspecific.

In these days of academies and free schools employing staff without specialised training to teach, the term ‘teacher’ has lost some of its protected status, and anybody who works in a school during the day from cleaners to ICT technicians has to attend child protection training about prioritising welfare. So you can see how they might have stretched some meagre credentials. Critically, it doesn’t state ‘welfare professional’ or name any specific roles such as ‘Head of Year’ or ‘Safeguarding Lead’

The introduction sets out its goal to “Manage the (se) issues” of official transgender schools guidelines.

The following content on Page 5 titled “why is it needed” is clearly anti-transgender rights and is scaremongering.

It is full of sensationalist soundbites equating gender non-conformity with sexual orientation, highlighting increases in referrals to gender clinics, and even implying that the internet is not to be trusted as it causes something they name ‘rapid onset gender dysphoria’ (thank goodness for Net Neutrality eh).

I almost give up at this point, I am not going to be reading their list of fallacies or ‘case studies’.

Both the title and details of the section ‘Transgender, gay, lesbian, ASD or troubled teenager?’is very offensive not least to children who have suffered abuse or who have ASD.

As schools we have been tasked by the DfE to promote fundamental British Values of:

The rule of law.

Individual liberty.

Mutual respect for and tolerance of those with different faiths and beliefs.

I don’t see how this document can fit within these modern values.

I see no way that schools would touch this publication with a barge-pole.

Schools are time and money poor, therefore no one will have the time to read it, or the money to print it.

The priority of school leaders is the safety of young people and ensuring that they make progress.

For teachers this means reporting concerns on to the correct person and spending hours preparing lessons, marking and reporting data.

This document includes bad, unsupported, advice coming from a website with a clear agenda of prejudice against the children it claims to support. Reading it is a waste of teacher’s time.

Without visibility this most vulnerable group of children continue to have their basic rights denied. All too often, trans allies and advocates avoid any reference at all to trans children – it’s too political, too controversial, or too outside of their personal knowledge. Trans children can just wait until they are 18 for fair treatment right? Maybe we can wait until the following generation, after trans adults achieve equality, and then consider trans children. Maybe your trans great grandchildren will be treated well.

Whilst trans advocates and allies pretend trans children don’t exist, the people who are left talking incessantly about children are those opposed to trans equality. Transphobes and trans-antagonists, railing ‘just think of the (cisgender) children’, ‘save them from the trans menace’!

Aside from a couple of notable exceptions (including Paris Lees) who exactly is speaking up for my child? Who cares about trans children?

For each submission I searched for the use of the term ‘child’ (a search which will also find any references to children, childhood etc).

My results were pretty interesting. More detail is at the bottom of the post, but I’ll summarise the key findings here:

Over half of the submissions (58%) gave zero references to children (trans or cis). This included the vast majority of submissions from transgender adults, the submissions from nearly all government departments, from MPs, from Police forces, from the Royal College of GPs, from Action for Trans Health, from the Albert Kennedy Trust.

A further 16% only used the term children in reference to the (presumed cis) children of trans adults, to intersex children, or in a phrase like ‘looked after children’. This included the British Association of Gender Identity Specialists and the General Medical Council.

Three quarters (74%) of submissions contained zero references to the existence of transgender children

15% had only one or two very brief references to transgender children, some of which avoid acknowledging the existence of trans children. Both NHS England and Stonewall only mention children in reference to the existence of a “Children’s Gender service“. The Equality and Human Rights Commission manages only two references to “gender variant children” or “children whose gender identity is less well-developed or understood than that of an adult”.

89% of submissions to the 2015 Women and Equalities Commissions Transgender Equality Inquiry either didn’t mention children at all, or barely mentioned them.

The remaining 11% of submissions is where I now turn my attention:

Submissions that referred to children more than twice:

Only 23 submissions (11%) referred to children more than twice.

These can be roughly divided into three categories:

a) 7 submissions (3%) were from anonymous parents of transgender children/transgender children – This included 6 parents of transgender children, and one trans young adult who had been treated in children’s services. These submissions contained credible and relevant real life information on transgender children (but there were only 7 submissions from the families affected). These submissions were all anonymous – a great indication of how voiceless these children are.

b) 7 submissions (3%) were from people or organisations whose submission is supportive or neutral towards trans people, these included:

FOCUS: The Identity Trust provides 3 references to transgender children and 2 to gender-variant children

GIRES provides 4 references to transgender children, but doesn’t use the term ‘transgender’, simply calling them children (though in the context the references are to trans or gender variant children)

Lancashire LGBT provides 16 references to trans children,

Mermaids provides 21 references to trans children, children referred to gender services or children with gender dysphoria

Peter Dunne provides 5 references to transgender children

Polly Carmichael from the Children’s Gender Identity Service provides 21 references to trans or gender variant children, yet fails to use the term transgender children even once, instead referring to a variety of terms including ‘children experiencing difficulties in their gender development’ ‘unconventional children’ ‘children with GID’ ‘Children with gender dysphoria’ ‘children with gender incongruence’

The British Psychological Society is rather a mixed bag with one reference to “rare cases it has been thought that the person is seeking better access to females and young children through presenting in an apparently female way”, with 1 reference to transgender children and 1 reference to children with gender dysphoria.

c) 9 submissions (4%) were from people or organisations whose submission is negative or antagonistic to trans people:

A specific person, SJ, refers to children in terms of the threat posed by adults “luring children into women’s toilets in order to assault them”

Evangelical Alliance provides 7 references to the need to protect children

Lesbian Rights Group provides 14 references to children including outlining the ‘pressures on young people and small children to transgender’ and highlighting the ‘transgendering of children – a matter of concern’.

A specific person, MY, includes 7 references to protecting children including ‘from possible parental or other abuse’ and recommends ‘treating the parents’.

The group ‘Parents Campaigning for Sex Equality for Children and Young People’ contains 65 references to children focusing predominantly on gender expression / toy stereotypes as well as on the need to protect against ‘transgendering children’

A specific person, SDA, provides 11 references to children focusing on gender expression/toy stereotypes and arguing the need to stop the ‘powerful trans activist lobby from pathologising normal childhood’ and arguing against ‘trans theory’

‘Women and Girls Equality Network (WAGEN)’, by Dr Julia Long, contains 13 references to children focusing on stereotypical gender expression/roles and arguing against ‘transgendering of children’.

These 9 trans-antagonistic submissions listed above contain 151 references to children. This is nearly more references to children than the other 199 submissions combined.

One qualification to the above research summary: I only searched for use of the word ‘child’ (or ‘children’). It is possible that some submissions focused on children without using the word children. Some submissions may, for example, have used the term transgender youth or adolescent – a more in depth analysis could consider more search terms – but arguably a decision to utilise the word ‘youth’ and avoid the word ‘child’ in a submission is itself a value judgement on the existence or not of trans children and is itself part of a culture of erasure of trans children.

Conclusion

Transgender children are almost completely invisible in society. Trans children need allies speaking up for them.

Yet over three quarters of submissions to the Women and Equalities Commission 2015 Transgender Equality Inquiry contained no acknowledgement of the existence of trans children.

The submissions with the most references to children (cis or trans) are those written by individuals and groups opposed to trans rights. Inputs on transgender children are overwhelmingly written by those ideologically opposed to supporting transgender people. Transphobic individuals and groups are being allowed to set the conversation on children, meaning the actual issues of enormous importance to trans children aren’t even on the agenda. The debate is instead being framed as between (trans-antagonistic or trans sceptical) people who care about protecting children versus trans adults. To re-frame this debate, we need trans advocates to talk about trans children.

Stop the erasure of trans children!

There were over 40 submissions from individual trans adults (or adults with a trans history/adults of trans experience). Almost none of these submissions from trans adults mentioned trans children. Parents of trans children are unable to speak openly (all submissions from parents were anonymous). Cisgender parents of trans children are also sometimes unsure about our credibility speaking out on trans issues. Trans children cannot speak for themselves. Someone needs to speak up.

Hardly any trans-supportive organisations mentioned trans children in their submissions. If your organisation only listens to the voices of trans adults, you are excluding the most vulnerable trans group. Organisations like Stonewall (whose 2015 submission ignored trans children) have a trans advisory panel consisting of only trans adults. Yet it is very clear from this review that transgender adults can’t be assumed to speak up for the needs of current transgender children.

Organisations aiming to support trans equality need to either work with parents of trans children (most of whom are cis, some of whom are trans), or, at the very least, make sure that at least one trans adult is designated to represent trans youth (reaching out to older trans adolescents directly) and we need at least one trans adult designated to represent trans children (reaching out to parents supporting trans children, as the stakeholders who best understand the very many challenges facing trans children).

Without proactive effort to engage with parents and families of trans children, trans children will remain voiceless.

The erasure of trans children in the 2015 submissions to the Trans Equality consultation is shocking.

We must do better for trans children.

Let’s start with the current Scottish GRA consultation (open to submissions from anywhere in the world – and we know those opposed to rights and respect for trans children are submitted from all over the world).

Please complete the short questionnaire on a reformed Scottish Gender Recognition Act. At a minimum please include in your submission acknowledgement of the existence of trans children. Better still, refer to the issues and challenges that affect trans children. If you don’t know any trans children – then get in touch with families of trans children, or organisations like Mermaids.

#SomeChildrenAreTrans #GetOverIt

Further info on the findings

Methodology

I looked at all 208 submissions to the Women’s and Equalities Committee’s Transgender Equality Inquiry.

For each submission I searched for the term ‘Child’ (a search which also found any reference to children, childhood etc).

Limitations of the research findings:

1) This research was carried out quickly to give an overview of the data. I looked at all 208 submissions, but quickly and without moderation of findings – some level of errors and oversights are likely.

2) The keyword used was ‘child’ (to include children). It is possible that some submissions focused on children without using the word children. Some may for example have used the term youth. Arguably the decision to utilise the word youth and not child is itself a value judgement on the existence or not of trans children and is part of a culture of erasure of trans children. The Gendered Intelligence submission uses the phrase ‘young trans people’ which refers to “people aged 25 and under”

Over half of the submissions (117 = 56%) gave zero references to children (trans or cis).

This included the vast majority of submissions from transgender adults, the submissions from nearly all government departments, from MPs, from Police forces, from the Royal College of GPs, from Action for Trans Health, from the Albert Kennedy Trust.

Another 16% (34), only used the word children when quoting the title of an NHS Department (eg Child and Adolescent Mental Health Services (CAHMS); in reference to the children of transgender adults, in a generic reference to childhood, in reference to intersex children, and in brief references to children in the phrase ‘looked after children’ or ‘children’s homes’. This group included the British Association of Gender Identity Specialists, the General Medical Council and Gendered Intelligence.

Organisations that refer once or twice to the existence of trans children

26 organisations (13%) had only one or two very brief references to transgender children, copied in table below:

Some of these avoided the term transgender children, only referring to ‘children in the gender service’ for example the single reference to trans children by Stonewall states “The Tavistock and Portman is the only specialist clinic, providing early intervention treatment for children and young people.” NHS England similarly only describes the ‘Children’s clinic’.

Table: Organisations that refer once or twice to transgender children

Organisation

Reference to transgender children

The Albert Kennedy Trust

“The right of the parent to support a child through their assignment is important.”

Genderagenda

“Typically, 1 child per class will come out to me and another will say I know someone trans/non-binary and ask for help supporting them.

The Government Equalities Office has one reference to trans children, quoting Ofsted

“Ofsted’s Common Inspection Framework, which takes effect in September 2015 and covers standard inspections of early years, schools and further education and skills providers, requires inspectors to pay particular attention to the outcomes of a number of specific groups, including transgender children and learners.”

A young trans adult makes one reference

“I feel that children are discovering what trans means through the internet rather than in a classroom environment, and I fear that as a result, either children would grow up with a slight bias, or children who are trans would not realise this until many years later, when it is more difficult to transition. “

LGBT consortium

“Medical interventions for children and adolescents have been inadequate and do not meet international best practice standards”

LGBT Youth Scotland

“Further, transgender young people are aware of their gender identity and begin living in their acquired gender far earlier than the age of 16. We recommend implementing provision which would enable parents and carers to give consent for a child or young person to receive a GRC under the age of 16”

National LGB&T Partnership

Medical interventions for children and adolescents have been inadequate and do not meet international best practice standards

Outreach Cumbria

‘Fourthly there is no local support for children and adolescents with gender identity difficulties with the nearest (and only) gender clinic being the Tavistock and Portman Clinic in London

A volunteer with the Albert Kennedy Trust

“Early access to transitioning and being accepted from a young age is vital to the emotional and mental well being of a trans person and therefore families, social services and the NHS should work with all trans children and trans youths to be able them to decide their future and how they wish to live.”

Support U

“Most of the above issues all apply to young trans people, although more education of peer groups of trans children would help”

Terry Reed

“Numbers presenting for treatment have grown at ~23% p.a. over the last couple of years. In the children and young people group, the growth is even faster.

inclusion of transgender people: adults, adolescents and children, in sport.”

Trans Media Watch

“Louis Theroux’s recent documentary on trans children for the BBC also received much acclaim

UK Trans Info

Provide a method for children and teenagers who are below the usual age requirement to obtain gender recognition with the consent of their parents or guardians, or without their consent through the courts where it is in their best interests.

Anonymous

“Ensure that those working in proximity with minors are aware how potentially transgender children can and should be helped.

Ensure the implementation of compulsory, trans-inclusive PHSE curriculum in order that children are made aware of the issues facing trans persons, help trans children access support, and tackle transphobic behaviour before it begins.

Without access to educational information and resources on gender identity, trans children may be placed under undue stress, confusion, and harm. Through the provision of compulsory gender identity education within the PHSE curriculum, work can be done to make trans children aware that they’re not alone, that discriminatory behaviour they may face is not acceptable, and of the support available to them.

University of Leeds

Particularly vulnerable groups include intersex bodied people and trans children under 18

Scottish Transgender Alliance

With growing social acceptance, the annual number of children and adolescents coming out as transgender has increased five-fold over four years

Anon

There is a need for a more robust communication / awareness programme to help parents who believe their children may be gender dysphoric , and how they can help and cope

Anon

A close family friend has a trans child who, age 8, told his teachers that he wanted to be a boy and have ‘boy parts’. The school reported his parents to the social services, assuming that the child had been abused, based on no other evidence

Individual

Studies indicate that the majority of trans people know they are trans by the age of 7, and many experience distress throughout their childhood. A growing number of children are transitioning, and the lack of any legal recognition until a child is 18 is starting to cause problems, for example with names in school systems and examination certificates.

Individual

Inclusion of trans history as a compulsory element of the UK schools national curriculum, linking it to organisational support for trans children, adolescents, their families, and their friends

Individual

We need to be intervening sooner, so that trans-children grow up with a chance of fitting in to society and being truly inclusive, and non-trans children will grow up with understanding and tolerance, rather than behaving in a segregatory manner and ostracising trans-people

Someone recently wrote in to this blog, saying, in essence, that they ‘would like to support trans children’s rights, but can’t get over a nagging fear that children who are simply non-conforming are being pushed into identifying as trans’. The writer remembers being a ‘tomboy’ who hated dresses, and fears that such traits in today’s society would lead to her ‘being pushed into being a trans boy’. She asks whether a ‘butch woman who identifies as a woman can still be a woman’.

This is the way that very many people who are ‘on the fence’ about supporting trans rights feel. It is not dissimilar to the way I myself once thought about trans people, back when I had never knowingly met a trans person, back before I knew my daughter, back when a lifetime of ignorant media portrayals had depicted trans people, almost always trans women, as clichés of femininity.

Anyone who finds themselves thinking this way, please take a minute to consider a few things.

First consider where are you getting your information from? Have you met trans people who you consider to be making their lives harder and facing enormous discrimination simply from ignorance that girls can climb trees and boys can like dolls? Or do you perhaps know very few or zero actual trans people, and you are basing your judgement on media portrayals? If the latter, consider whether such media tropes are written by, directed by and feature trans people, or whether they simply project non trans (cis) people’s interpretation.

Second, can you really scrutinise the first statement – that you would like to support a marginalised group’s rights, but only once you have been persuaded by them that they deserve your support. Only once you have been persuaded that they are not naively/stupidly enthralled to stereotypes.

Can you not hear how that sounds?

It is not dissimilar to someone saying ‘yes I’ll support Muslim rights, as soon as they persuade me they’re not all terrorists’, or ‘yes I’ll support the rights of people on benefits, as soon as they persuade me they’re not lazy’ or ‘yes I’ll support asylum seekers rights, as soon as they persuade me they’re not criminals’.

I’m all too aware that certain people on the far right in our society hold all of these prejudiced views.

There is a mainstream portion of our society who would never dream of stating or even thinking those statements. Who understand that these sentiments and generalisations are grounded in media misrepresentation, ignorance and hate. Who would not buy into media vitriol about other minorities, yet fall into the trap of believing that trans rights, and trans children’s rights, need to be earned, can be withheld, are in some way conditional upon those children (and their parents) proving that their specific trans child is not a stereotype, and is not in fact a non-conforming child ‘forced into a trans identity’.

The insinuation that trans children are just non-conforming children being led astray is pervasive, a scare story proactively spread by those who want to marginalise trans people.

This accusation is thrown at parents like myself daily:

Why couldn’t you just let your boy play with dolls? (…she doesn’t like dolls)

Why couldn’t you just let him do ballet and wear a princess dress (…she likes football and prefers witches)

Those accusing us of stereotypes are the ones seemingly obsessed with outdated notions of gender specific toys and interests.

They worry that parental narrow mindedness or ignorance leads us to presume a ‘tom boy’ must be a trans boy, that a feminine boy must be a trans girl.

Because of course us blinkered parents of trans kids are tied to stereotypes and couldn’t love a non-conforming child.

Because of course, in their mind, all trans girls love pink and dolls and sparkly tiaras, and all trans boys must be ‘tom girls’ who hate dolls and dresses.

Having met many score of trans children, this couldn’t be farther from the truth. Trans children, and trans people in general are those who are tearing down the gender boundaries.

Of course we told my daughter that she could be whatever type of boy she wanted to be. This was totally misunderstanding the point and made our child deeply sad.

It is true that media depictions of trans children often focus on gender stereotypes, with pink = girl.

Every time I see any depiction of trans kids on TV I count the seconds until the trans girl pulls out a doll or the trans boy kicks a football. But guess what. I know scores of trans girls who had zero interest in dolls or dresses. I know trans boys who collect dolls.

Trans children are no more stereotypical than any other children.

The same for trans adults of course. Some trans women are extremely glamorous and feminine (just like I know some cis women who are always in dresses and makeup). Some trans women wear jeans and t-shirts and rarely if ever use makeup – just like me and tons of cis women. Gender expression is not the same as gender identity.

If you are ‘on the fence’ about whether to stand up for trans children, please question where you are getting your assumptions about transgender children from. If it is coming from a transphobic and ignorant media, or if it is coming from anti-trans children political groups, consider if the information you receive is biased, loaded or spun. Would you accept rhetoric about Muslims from Britain First?

On Media Tropes of trans children

I’ve identified three key factors why the vast majority of media does not present a true picture of trans children:

Media stereotyping

Societal expectations

Personal narratives (of children and families)

1. Gender stereotypes are pervasive in media coverage of trans children. There are many reasons for this:

Media stereotyping: TV shows regularly confuse gender identity with behaviour, toys or interests. Some media pieces seem to do this maliciously, to undermine the validity of trans children, to suggest to unaware viewers that non-conforming children are being made trans. In other media pieces the stereotyping may be unconscious. This is particularly the case when transgender people (directors, producers, narrators) are not involved. Many (but not all) trans adults and parents of trans children are acutely aware of the distinction between trans and gender non-conforming – and of the difference between gender expression and gender identity

Simple soundbites: Documentary producers often seek to tell a simple story, and select and edit soundbites to fit their narrative. This usually reinforces a ‘traditional’ and expected depiction wherein gender expression (eg clothing) and toy preferences (boys = trucks, girls = dolls) are highlighted as synonymous with gender identity. The public as a whole is still poorly informed – many people don’t know what the term gender identity means, many have never heard the term cisgender, or assigned gender, and some are unsure whether a trans girl is someone who was assigned male or female at birth. Documentaries need to ‘hold the hands’ of an ill-informed general public, taking small bite size steps into the world of gender identity. In this context, it is hard for a brief media piece to quickly convey complex and nuanced information on identity. It is much easier to revert to old clichés to help tell the story, looking for soundbites like ‘I adored dolls when I was little’ or ‘I was born in the wrong body’. I’m not denying that some trans people do say these things, and for some trans people this is their truth. But this is not the heart of the story for very many trans people, yet these same clichéd and simplified stories are the ones we see in the media time and again. Reporting on adult trans people seems to be moving towards more complex and nuanced stories about identity – not yet so for trans kids.

Simplified Visuals: Documentary makers like to use imagery to tell their story. A gender identity is not something that can be photographed or visually depicted. Trans kids, like all kids, will have items of clothing of a variety of colours. But it is the photo of a trans girl wearing pink that will make the documentary, that will be selected for the front cover. Trans girls, like most cis girls, will sometimes wear pink. Indeed it is hard to avoid pink in the girls section of most stores. Media images of trans girls almost always show them in pink – this does not mean trans girls wear pink any more often than cis girls. My trans daughter actively dislikes pink.

Participant selection: Some trans girls like football and trousers and climbing trees. Some trans girls like dolls and princesses and pink. Documentaries will give greater emphasis to the latter over the former (I hardly ever see the former shown, despite knowing plenty of trans girls who would rather climb a tree or play a computer game than dress as a princess). Many trans girls will like a wide range of toys, both dolls and cars and will gladly play with both. Which footage will make it into the documentary though? Of course, it will be the clichéd footage of the trans girl with the doll. This is very similar to the clichéd media portrayal of trans women always being introduced showing them putting on make-up. This is part of the truth for some people, but it is manipulative – emphasising stereotypical and clichéd aspects of lives that are rich, nuanced and complex.

2. Gender stereotyped expression may also be more prevalent in trans children, at some stages of their life due to external pressures

Medical gatekeeping: Adult gender identity services, for a very long time, insisted that trans women adhere to restrictive (and often outdated) gender stereotypes as a condition of acceptance for treatment. Trans women who might out of preference dress in a less stereotypically feminine manner were forced to conform to outdated stereotypes in terms of dress and hair style, or be denied support. This type of regressive gatekeeping is still experienced in children’s services, with reports of trans teenagers being told they need to ‘dress in a more stereotypically feminine manner’ or ‘need to sit in a more masculine posture’, or wear certain clothes, or style their hair in certain ways.

Securing support from other children: Trans kids want to gain the support of their peers. Adhering to a very stereotypical gender presentation is a way of signalling their gender identity to other children. When my child was trying to persuade her peers to address her as a girl she took to wearing sparkly hair clips as a visual queue of her identity. One day in the car en route to a party she lost her hair clips. She descended into uncontrollable sobs. When questioned she explained:

‘If I don’t have hair clips in, they will call me a boy’.

Since being accepted as a girl by all her peers, she soon stopped wearing hair clips. It was never about the hair-clip – it was about wanting to be seen by others and respected as a girl.

Asserting identity to parents: Trans kids desperately want to show their parents their identity. Clothing is an obvious route to asserting identity. When we were calling her a boy, my child refused to wear trousers (from a very young age). A very rigid and strident insistence on wearing dresses is for many trans girls a way to communicate their identity to their parents. Gender non-conforming boys like to wear dresses because they like the dress, maybe it sparkles, maybe it has a fun pony on it, maybe it is brighter than the dull colours in the boys section. But for transgender children, clothing is a means to an end, a useful way of trying to communicate and assert their identity. How do you know if it is a gender non-conforming boy or a trans girl? Listen to what the child is saying. Are they focused on liking dresses? Gender non-conforming child. Are they consistently, persistently and insistently saying ‘I am a girl’ and getting deeply upset and depressed when called a boy? That was our daughter. Once our daughter was accepted by us as a girl, her clothing choices gradually shifted to what is now a fairly neutral presentation for a girl – sometimes wearing dresses but most of the time preferring leggings or jeans.

3. Narratives of the child and their parents

Some parents of trans children like stereotypes and some parents like simple narratives that help explain their situation to a sceptical world: Parents of trans kids come from all walks of life. This is not an ideology that only parents with a certain world view sign up to. Trans kids appear in all kinds of families. These families are as varied as wider society, and the families of trans kids will mirror the views and prejudices of wider society.

Some parents of trans kids have very stereotyped and gendered expectations for their children. These parents, when recalling the childhoods of their transgender children, will remember and highlight examples of non-gender conforming behaviour. Such families may well say ‘It made sense that she was a trans girl, as she always liked dolls’. This does not mean that playing with dolls made the parent conclude their child was transgender, rather it meant that once she accepted her child as a girl, she recalled and emphasised examples of non-conforming behaviour that help her understand and accept her child.

Other parents do not have gendered or stereotyped views of children. These parents do not see any clear and simple correlation or causation between the clothes or toys that our children preferred, and their gender identity. Such parents present a more complex and less ‘packageable’ narrative. Such parents do not produce the short media friendly soundbites that documentaries rely on. This more complex parental narrative almost never appears in media depictions of trans children – instead media prefers the parents who say “my child loved dolls so I knew she was a girl”.

Some children need a simple answer: Our daughter has always known she is a girl. Like many children asked to explain her gender identity she cannot do so easily and simply. She quickly got tired of being asked “but why do you think you are a girl?” Gender identity is hard to explain, and adults would struggle to find an answer beyond ‘I just do’. When children assert an identity different to what was expected there is undoubtedly societal pressure to justify how they feel in some way. It would not be surprising to me for children to gravitate to emphasising examples of their own non-conforming behaviour or interests as extra justification for who they are. Especially when this is the depiction of trans children they see in the media. Especially when even the diagnostic criteria used by children’s gender identity services (in the UK and elsewhere) requires stereotypical ‘cross gender interests, behaviour, play preferences’ as credentials for being considered transgender (Gender Identity alone is not sufficient, children are expected to conform to stereotypes of behaviour, clothing or play preferences in order to be deemed gender dysphoric).

There is a popular children’s book written by a transgender girl called “I am Jazz” that seems to equate her liking ‘girls activities’ with being a trans girl. When I first read it with my trans daughter she noticed this and said “that’s silly, of course boys or girls can both like dancing/pink/ballet”. My trans daughter has a more nuanced understanding of the difference between identity and interests. And she shares my dislike of gender stereotyping.

It is possible to criticise some books and programmes about trans children as reinforcing stereotypes without jumping to a rejection of transgender children.

It is possible to dislike gender stereotypes and still want trans children to have happy and safe lives.

It is possible to want the best for gender non-conforming children and still want trans children to be treated with respect, dignity and acceptance.

Those of you on the fence about trans rights can carry on weighing up whether my daughter has proved her ‘not a stereotype’ credentials enough to be shown kindness, respect and acceptance.

I meanwhile will carry on raising a kind, confident, happy child.

I will carry on helping all my children to see beyond the stereotypes, limitations and restrictions society places on girls and boys (and non-binary people).

And I will teach them the importance of tolerance, kindness, and respect, especially for those who we don’t understand, especially for those who are different.

The perception that trans children are ‘too young’ to know their gender identity is used as a basis for denying them a suite of rights, and has long been a corner stone of arguments against social transition or timely provision of puberty blockers.

Cisgender (not trans) children are generally considered to know if they are a boy or a girl by a young age. But, not so for transgender or gender questioning children, according to the latest paper written by experts from the UK Children’s Gender Service, including the head of service Carmichael.

UK Children’s Gender Service experts’ view of Gender Constancy

The Costa (2016) paper has a section on gender identity development. It states that “research has shown that around the age of 3 years, children show a basic sense of self as male or female, owing to their inner experience of belonging to one gender”.

It goes on to note:

“Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour” (reference number 16).

According to the paper “achieving gender constancy represents a cognitive-developmental milestone in gender identity development and is due to the understanding that being male or female is a biological characteristic that cannot be changed by altering superficial attributes, such as hairstyle or clothing”

The belief in trans children having a ‘developmental lag’ in gender constancy leads to this statement “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults”

The belief in trans children having ‘a developmental lag” in gender constancy feeds directly into the Tavistock’s treatment protocols, such as proposing puberty suppression only be prescribed to those aged at least 12 “safely above the gender constancy achievement”.

Only one reference is provided for the claim that transgender children achieve ‘gender constancy’ later than cisgender children, reference 16, which is the source of this key statement:

“Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour (reference 16)

If this single reference underpins the Tavistock’s belief that trans children do not understand their gender at the same age as cisgender children, and if this claim has direct implications on the Tavistock’s approach to treating trans children, then it is vital we review this paper.

Zucker (1999)

Gender constancy in the Zucker paper is defined as “the understanding that ‘superficial’ or surface transformations in gender behaviour such as activity preferences or clothing style” do not change a person’s gender. The paper concludes that children referred to a Gender Clinic for ‘problems in identity development‘ have a ‘developmental lag in gender constancy‘. This conclusion merits further scrutiny.

Zucker et al.’s study focuses on a group of children who were referred to the Toronto Gender Clinic between 1978 and 1995.

The majority of the Gender Clinic children in this study were assigned males (207/236 = 88%). There were a small number of assigned females in the sample (12%). In order to simplify this blog post I have decided to focus the examples throughout on assigned males (noting that this editorial simplification perpetuates historical erasure of trans boys / assigned females).

The children registered at the Gender Clinic I will hereafter refer to as the ‘clinical sample’, to contrast with the study’s ‘control sample’ (a sample of children of the same age who were not registered at the gender clinic and were not known to have any gender issues).

It is known (and acknowledged in Zucker’s paper) that some of the clinical sample of assigned males were non-conforming boys rather than trans girls. How many were gender non-conforming (GNC) rather than trans is unknown as historical diagnoses focused on behaviour and interests more than on identity and Zucker did not believe in distinguishing between young gender non-conforming boys and trans girls.

The children in the clinical sample, together with a control group (aged 4-8 – average age 6 and a half) were put through three different types of test, which they either ‘passed’ or ‘failed’.

Zucker 1999, the tests

We will now look at the three tests, and see whether they do provide convincing evidence that transgender children (or children treated in the gender service) have a ‘developmental lag’, and understand their gender identity later than cisgender children.

Zucker 1999: Test 1: Slabey & Frey test

Test 1 Part A focused on Gender Discrimination

The children were shown dolls and photographs depicting a boy, girl, man, woman and asked to identify them. The children ‘passed’ if they got at least 12 out of 16 ‘correct’. 93% of the clinical sample ‘passed’ this test, compared to 98% of the control group.

Test 1 Part B: Gender Identity

The children were asked their own gender. The assigned-male-at-birth (amab) children ‘passed’ the test if they answered ‘boy’.

93% of the clinical sample ‘passed’ this test compared to 98% of the control group.

(The very high ‘pass’ rate for the clinical sample at first glance seems high as transgender children like my daughter would certainly ‘fail’ this test.

Perhaps the high ‘pass’ rate may add weight to suggestions that a large proportion of children referred to the Toronto gender clinic in the 1970s, 1980s and early 1990s were there for gender non-conformity (proto-gay cure….) rather than children with a gender identity different to their assigned sex.

The fact that a trans girl was considered to have ‘failed’ in her understanding of gender identity if she said she was a girl is an indication of the bias of the researchers.

Test 1 Part C: Gender Stability

The children were asked if their gender can change over time, for example if they were a different gender when they were born to their current gender. The children ‘passed’ if they said gender can never change over time.

80% of the clinical group ‘passed’ compared to 92% of the control group

Test 1 Part D: Gender Consistency

The amab children were asked questions like ‘if you wear a dress, are you a girl?’ ‘If you played with a doll would you be a girl?’. (the exact script, and the exact phrasing, is not provided so we cannot be sure exactly how the questions were worded)

66% of the clinical sample ‘failed’ this test, by stating that playing with dolls makes you a girl.

46% of the control group also ‘failed’, also thinking that playing with a doll made you a girl.

The fact that nearly half the control also think playing with a doll makes you a girl seems more an indication of the segregated and gendered restrictions on toys of Canadian children in the 70s, 80s and early 90s than any conclusion about gender identity. Given very few of the clinical group identified as trans in this study, it also brought to mind the limited freedom for boys to be feminine or play with perceived girls toys, and made me wonder how many assigned males had been told to ‘stop being a girl’ when playing with dolls or putting on a dress.

Zucker 1999 Test 1 – Conclusion

The data from test 1 parts A-D, and the fact that the clinical sample had a slightly lower ‘pass’ rate than the control sample, was interpreted by Zucker et al. as evidence that children at the gender clinic were more ‘confused’ about gender.

The researchers then take a further leap of faith, into a conclusion that the lower pass rate of the clinical group compared to the control group implied a ‘developmental lag’ in understanding of gender. However, the clinical sample and the control sample were the same age (ages 4-8, average age 6.5), and the clinical sample were not re-tested at a later point in time. How therefore can they claim a developmental lag? It is simply not possible to claim a ‘developmental lag’ based on this data. The assertion of a ‘developmental lag’ (with the implication that the clinical sample reach a similar level of understanding but at a later age than children not referred to a gender clinic) is pure speculation/fabrication.

Test 1 provides zero evidence that transgender children (those with a consistent, insistent, persistent identity different to their assigned sex) have a delayed understanding of gender.

Zucker 1999: Test 2 Boy-Girl Identity Test

The assigned male children were then shown a drawing of a boy. They were asked to give the child in the drawing a name. If they chose a girl’s name for the drawing they were corrected and given a boy’s name, eg ‘this is Tom’.

Zucker 1999 Test 2 Part 1:

The children were asked ‘If Tom really wants to be a girl, can he be a girl?’.

The children ‘fail’ this test if they say yes Tom can be a girl.

32% of the clinical sample ‘fail’ this task by stating Tom can be a girl vs 21% of the control group

(Interestingly there is not a huge difference between the clinical group and the control group, with 21% of the control group, children with no gender issues, thinking that yes, Tom can be a girl – Canadian 5 year olds from the 1970s, 1980s and early 1990s showing more sophisticated understanding of gender than their specialists…)

The children are asked to give a reason for their answer, and are defined as having reached ‘operational constancy’ if they justify their answer ‘No Tom can’t be a girl’ answer with the justification ‘because he was born a boy’.

This unethical line of questioning Zucker et al put trans children through is a form of coercive persuasion, tantamount to brainwashing, where the ‘wrong answer’ is corrected with the ‘right answer’ – ‘BECAUSE TOM WAS BORN A BOY’ until the child submits and agrees.

Zucker 1999 Test 2 Part 2:

A dress and or long hair is added to the picture of ‘Tom’ and the children are asked ‘If Tom puts on a dress, is he a girl?’ The expected ‘correct’ answer is ‘No’ and the expected justification is ‘because he was born a boy’.

71% of the clinical group ‘fail’ this test, as do 64% of the control group.

Again the control group is pretty similar to the clinical group in their openness to the possibility of Tom being a girl.

Zucker 1999 Test 3 Part 1 asks children to draw a person, and then asks them if the person they have drawn is a boy or a girl.

The assigned male at birth children ‘pass’ if they opt to draw a boy and ‘fail’ if they opt to draw a girl.

66% of the clinical sample ‘fail’ by drawing a girl (in case of the assigned males). 54% of the control sample also ‘fail’ this test by drawing a girl (in case of the presumed cis boys).

Again the results of the control are fairly similar to the clinical group.

Again there is no evidence of trans children having a developmental lag in understanding gender.

Zucker 1999 Task 3 Part 2 has the children watched through a 1-way mirror in a room with ‘gender specific’ toys and or clothes and the researchers assess the amount of time the children spend with ‘appropriately gendered toys or clothes’. They are deemed to have ‘failed’ if they play too much with the ‘wrong’ gender toys or clothes.

This task has no place in today’s society in which children are not constrained by outdated gender stereotypes.

Zucker 1999 Task 3 Part 3 assesses what it calls ‘affected confusion’, assessing a child’s ‘desire’ to be a boy or a girl (rather than their identity). It asks assigned males (who have been referred to a gender clinic for non-conforming behaviour) questions like ‘is it better to be a boy or a girl’ and ‘do you ever wish you were a girl’. Assigned males are deemed ‘deviant’ if they state any wish to be a girl (perhaps because they are a trans girl or perhaps because they are a non-conforming boy who wants to be able to play with his dolls in peace without being taken to Dr Zucker every month/week…). Assigned males are also deemed ‘deviant’ if they acknowledge anything positive about girls or think that there are any ways in which it is better to be a girl than a boy.

64% of the clinical group are labelled ‘deviant’ due to their answers in this part, as are 50% of the control group (reminder the control group are ‘random’ children not being seen by the gender clinic and who are not known to have any gender issues and yet half are deemed by this test to be ‘deviant’).

Zucker 1999 Test 3 Conclusion

What on earth is going on, and how the heck is this research still being quoted in a 2016 journal article by the leading experts at the UK’s Children’s Gender Service!

The high ‘failure’ and ‘deviancy’ rate’ not only in the clinical group but also in the control group is perhaps indication that Canadian 5 years olds in the 70s, 80s and early 90s were did not have such ingrained stereotypes of gender, nor sexism, nor misogyny, as the ‘gender specialists’ who subjected them to such awful tests.

The Zucker 1999 article ends with a ‘blame the parents’ conclusion, proposing that parents of gender non-conforming boys or trans girls must have ‘actively’ encouraged ‘cross-dressing’ or appeared to ‘tolerate’ cross-gender behaviour. It highlights a view that “parental reinforcement of same-sex play was positively related to gender constancy in pre-schoolers”. It is pure ‘drop-the-barbie’ Zucker, more focused on installing out-dated gender conformity in non-conforming boys than any concern for how to help children who may be transgender.

Zucker 1999 in summary

To summarise, the Zucker 1999 research is deeply outdated, transphobic, stereotyped, homophobic, normative and unethical.

The clinical sample is known to contain at least some children who are non-conforming rather than trans and no effort is made to focus specifically on trans children.

The difference in answers between the clinical group and the control group are very small (the paper conducts regression analysis on a wide number of variables until it finds some that are considered statistically significant – this is an unsound approach to valid statistical analysis).

The study looks at a range of things that do not relate to gender identity (including toy preferences).

And most critical of all – the paper looks at the children at one moment in time – comparing the clinical group to a control group of children the same age (age range 4-8). There is no follow up at a later age and no comparison of children of different ages. Any claim to transgender children having a developmental lag (which I interpret to mean achieving a similar understanding of gender at a later age) is pure fabrication.

Given the obvious weaknesses of the the Zucker paper – why is it a core reference in the 2016 Costa paper from leading experts of the UK Children’s Gender Service

UK Children’s Gender Service

There are three major problems with the Tavistock’s view of gender constancy as shown in the Costa 2016 paper.

Problem 1 – Quoting fabricated conclusions as though evidence

The Costa 2016 paper states “Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour”, referencing the Zucker 1999 paper.

As we’ve seen above, the Zucker 1999 research does not provide any evidence for this claim.

Problem 2 – Broadening the relevance of those unsound conclusions and applying them to clinical practice

The Zucker paper mentions a ‘developmental lag’, but does not mention any age at which transgender children reach ‘gender constancy’.

The Costa 2016 paper moves beyond even the conclusions claimed in Zucker 1999, taking a series of assumptions to extrapolate wider conclusions (for which no specific reference is provided). They move from the idea of ‘a developmental lag in gender constancy’ to the claim that “children with gender dysphoria are more likely to express an unstable pattern of gender variance”. They move from that unsupported statement to the claim that “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults”. And they shift further to arrive at the final statement that puberty suppression is unwise until at least age 12 “safely beyond the age of gender constancy”. It is important to recall that Zucker 1999 provides no information on the age at which trans children ‘achieve gender constancy’ and focuses on children aged 4-8 (where the Costa paper get the age 12 figure from for gender constancy is anyone’s guess).

The Zucker 1999 research bears no relevance to the question of whether trans children understand their gender. Yet Costa et al 2016 use this study as their basis to suggest that transgender children do not know their gender. They use it to support an argument that transgender children have ‘unstable gender variance’ up until puberty, and they extend this to argue against pubertal suppression for those starting puberty under the age of 12.

Problem 3 – Omitting reference to critical recent research

The third, and perhaps the biggest error, is one of omission. The Costa 2016 paper, in its section on gender identity development / gender constancy in transgender children, only mentions the Zucker research, omitting mentioning any other research on transgender children’s gender identity.

The Zucker 1999 research paper is now 19 years old. Surely in the last two decades there has been some other research on the gender identity of transgender children, ideally research that makes an effort to focus on transgender (rather than gender non-conforming) children, and research that focuses on the children’s gender identity rather than toy preference? The answer is a clear yes. There are important studies on this topic that the Costa 2016 paper fails to even mention.

So let’s take a brief review of recent research on this topic which are noticeable by their absence:

New research on transgender children’s gender identity

Olson 2015

The introduction to the Olson el al 2015 paper describes historical (and current) scepticism to the idea of transgender children knowing their gender:

“This scepticism takes many forms: concerns that these children are “confused” and that they therefore need therapy, that these children are “delay[ed]” in their understanding of gender in part because of the behaviour of their parents (Zucker et al., 1999: Gender constancy judgments in children with gender identity disorder: evidence for a developmental lag), or that these children are merely saying they are the “opposite” gender, much as they might say on any given day that they are a dinosaur or princess.”

Olson et al.’s research aimed:

“to investigate whether 5- to 12-year-old prepubescent transgender children (N = 32), who were presenting themselves according to their gender identity in everyday life, showed patterns of gender cognition more consistent with their expressed gender or their natal sex, or instead appeared to be confused about their gender identity.”

Results:

“When the transgender children’s responses were considered in light of their natal sex, their responses differed significantly from those of the two control groups on all measures. In contrast, when transgender children’s responses were evaluated in terms of their expressed gender, their response patterns did not differ significantly from those of the two control groups on any measure.”

Conclusion:

“Using implicit and explicit measures, we found that transgender children showed a clear pattern: They viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender (nontransgender) control groups. These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity.

Our findings refute the assumption that transgender children are simply confused by the questions at hand, delayed, pretending, or being oppositional. They instead show responses entirely typical and expected for children with their gender identity.

The data reported here should serve as evidence that transgender children do indeed exist and that their identity is a deeply held one.”

Fast 2017

“An increasing number of transgender children—those who express a gender identity that is “opposite” their natal sex—are socially transitioning, or presenting as their gender identity in everyday life. This study asks whether these children differ from gender-typical peers on basic gender development tasks. Three- to 5-year-old socially transitioned transgender children (n =36) did not differ from controls matched on age and expressed gender (n =36), or siblings of transgender and gender nonconforming children (n =24) on gender preference, behavior, and belief measures. However, transgender children were less likely than both control groups to believe that their gender at birth matches their current gender, whereas both transgender children and siblings were less likely than controls to believe that other people’s gender is stable.”

Summary

So what do we know about gender constancy/ gender identity in transgender children?

We know that some claims are balderdash (junk science):

The Zucker 1999 study holds no value in informing us about the gender identity development or constancy of transgender children.

The statement “a developmental lag exists in gender constancy acquisition in children with gender variant behaviour” is unsubstantiated and shouldn’t be quoted in future articles

Conclusions in the Costa (2016) report on “children with gender dysphoria are more likely to express an unstable pattern of gender variance” and “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults” are unsubstantiated and should be disregarded

Policy recommendations in the Costa (2016) report on withholding pubertal suppression until “at least the age of 12, safely beyond the age of gender constancy” are unsubstantiated and should be disregarded

We know that recent research (Olson 2015 and Fast 2017) shows that:

“Transgender children do indeed exist and their identity is a deeply held one.”

“Three- to 5-year-old socially transitioned transgender children did not differ from controls or siblings on gender preference, behaviour, and belief measures.”

“Transgender children aged 5-12 viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender control groups.”

“These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity.”

Research “findings refute the assumption that transgender children are simply confused by the questions at hand, delayed, pretending, or being oppositional. They instead show responses entirely typical and expected for children with their gender identity.”

But with the greatest love and respect to all the wonderful advocates on that list (and to the far greater number of amazing advocates who were not on that list) that has got to be the Worst Power list ever!

Where are the trans MPs?

Where are the trans judges?

Trans newspaper editors?

Trans media barons?

Trans billionaires?

The fact that a UK trans power list includes cis parents who blog and tweet anonymously is a great indication of where the power currently lies.

Unless we just haven’t yet been initiated into the ‘all powerful trans lobby’……

Since 6-year-old Jazz Jennings appeared in a 2007 US documentary, the social transition of young transgender children has rarely been out of the media. With increasing awareness accompanied by increasing evidence of the mental health benefits of acceptance and affirmation, more parents across the world are supporting their transgender child to socially transition.

For children of any age, gender transition means allowing the child to choose how they express their gender. Children may:

Wear clothing that affirms their gender, such as skirts for transgender girls

Adopt a hairstyle that affirms their gender, such as a short haircut for transgender boys

Choose a name that affirms their gender

Ask others to call them by pronouns (such as “he” or “she” or “they”) that affirm their gender

Use bathrooms and other facilities that match their gender identity”

Social transition is completely reversible if the child determines it’s not right for them.”

Some ‘experts’ in Europe, in opposition to experts in North America and Australia, caution against social transition. A example of a European ‘expert’ cautioning against social transition is a 2017 Swedish publication on transgender children by Louise Frisen et al:

The Frisen article has some positive sections, but it does also include some outdated statements that I am weary of reading in journal articles:

“Follow-up studies show that no more than about 20 percent of pre-puberty children who meet diagnosis criteria for sex dysphoria will have a residual desire for gender confirmation [6-8].”

And I was shocked to see this recommendation:

“Restraint for the younger with early social transition

Since no more than about 20 percent of prepubertal children who meet gender diagnosis criteria will have a residual desire for gender confirmation [6-8], the recommendation for the younger children is restraint regarding early social transition (living as the perceived gender). It is important to discuss the social consequences and to be aware that the majority of the younger children will not have a remaining desire for gender confirmation.”

The recommendation against social transition, and the two statements quoted above rely on just three sources:

The above reference 6 (Drummond) and reference 8 (Wallien) are two discredited studies on desistance that have been widely criticised see here

Reference 7 (Steensma) is a study with totally unreliable conclusions, as discussed here:

The Swedish paper contains no acknowledgement that the data it quotes on the number of transgender children continuing to be transgender as adults are highly contested and could be completely wrong as discussed here

I am so tired of seeing these same unreliable (unscientific, unethical, unsound, shambolic) studies trotted out time and again in journal articles.

Parents of transgender children do not normally have the time, the access to the referenced literature (in inaccessible / expensive academic journals) or the capacity to fact check the advice they are given. And they should not have to. This is literally the job of the supposed experts writing papers like this latest Swedish one. The reliance on discredited studies and conclusions is deeply worrying.

And the advice against social transition can cause serious harm.

he Swedish study advising against social transition is worrying, not only due to the inclusion of unreliable/discredited research in their paper as discussed above, but also due to the exclusion of critical information that Swedish parents (and those caring for Swedish transgender children) have a right to know such as research demonstrating the benefits of social transition, and the positions of world leading experts from the American Academy of Pediatrics and ANZPATH, both of whom endorse social transition.

The Swedish paper does not mention the latest research study from Olson in the United States showing that socially transitioned and supported children have higher levels of mental well being than children who are living as their natal sex:

“Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.”

“In many cases, the remedy for dysphoria is gender transition: taking steps to affirm the gender that feels comfortable and authentic to the child. It is important to understand that, for children who have not reached puberty, gender transition involves no medical interventions at all: it consists of social changes like name, pronoun and gender expression.

While acceptance and affirmation at home can help a great deal, children do not grow up in a vacuum, so even children with supportive families may experience dysphoria. Nonetheless, families and doctors of transgender children often report that the gender transition process is transformative — even life-saving. Often, parents and clinicians describe remarkable improvements in the child’s psychological well-being.

The American Academy of Pediatrics describes social transition as “transformative – even life saving”. They continue:

A child’s gender transition is almost always a positive event. Often, the child’s debilitating gender dysphoria symptoms lift, diminishing difficult behavior that came with them. Dr. Ehrensaft calls this the ex post facto (“after the fact”) test: a dramatic reduction in stress, and blossoming happiness for the child and family, indicate that social transition has been the right choice. Along with joy at this renewed well-being, families are often thrilled to find that gender transition removes the emphasis on gender in a child’s life. With their gender identity no longer in conflict, the child can focus on the important work of learning and growing alongside their peers. Many children feel relief, even euphoria, that the adults in their life have listened and understood them.

This describes exactly our experience. Over night our daughter went from incredibly sad and distressed to a happy, carefree child. She went from wanting to talk about gender every single night to completely losing interest in the topic once the world was set to rights as we had accepted her as a girl.

The American Academy of Pediatrics are also very clear why those who, like the Swedish experts, advocate for delayed transition for all children, are wrong:

Delayed Transition: Prolonging Dysphoria

“delayed transition prohibits gender transition until a child reaches adolescence or even older, regardless of their gender dysphoria symptoms.

There is evidence that both reparative therapy and delayed transition can have serious negative consequences for children”

Many children who are gender-expansive or have mild gender dysphoria do not grow up to be transgender — but these are not the children for whom competent clinicians recommend gender transition.”

Delayed-transition advocates treat unnecessary or mistaken gender transition as the worst-case scenario, rather than balancing this risk with the consequences of the delay.

Untreated gender dysphoria can drive depression, anxiety, social problems, school failure, self-harm and even suicide.

There is no evidence that another transition later on, either back to the original gender or to another gender altogether, would be harmful for a socially transitioned child — especially if the child had support in continuing to explore their gender identity.

While delaying a child’s gender exploration can cause serious harm, a deliberate approach is wise. Some children need more time to figure out their gender identity, and some do best by trying out changes more slowly. For these children, rushing into transition could be as harmful as putting it off. The problem with “delayed transition” is that it limits transition based on a child’s age rather than considering important signs of readiness, particularly the child’s wishes and experiences. A gender-affirmative approach uses this broader range of factors, with particular attention to avoiding stigma and shame.”

For children with mild gender dysphoria, the family and therapist’s affirmation of their gender expansive traits often relieves their distress. For this group, it appears that gender dysphoria — and even a moderate desire to change gender — can result from trouble reconciling their masculinity or femininity with being a girl or boy. Adolescents affirmed in their gender-expansive traits are happier and healthier, whether or not they grow up to identify as transgender.

Other children have an insistent, consistent and persistent transgender identity; they thrive only when living fully in a different gender than the one matching the sex assigned at birth. In differentiating these children from the gender-expansive children described above, clinicians use two general rules: They focus on a child’s statements about their sex and gender identity, not their gender expression (masculinity or femininity), and they look for “insistent, consistent and persistent” assertions about that identity. Clinicians help these children and their families socially affirm the child’s gender identity.

The latest ANZPATH (Australian Professional Association for Transgender Health) provides similar clear, evidence based guidance for those supporting transgender children:

“Increasing evidence demonstrates that with supportive, gender affirmative care during childhood and adolescence, harms can be ameliorated and mental health and well being outcomes can be significantly improved.

Social transition should be led by the child and does not have to take an all or nothing approach.

Social transition can reduce a child’s distress and improve their emotional functioning. Evidence suggest that trans children who have socially transitioned demonstrate levels of depression, anxiety and self-worth comparable to their cisgender peers.

The number of children in Australia who later socially transition back to their gender assigned at birth is not known, but anecdotally appears to be low, and no current evidence of harm in doing so exists”.

Acceptance = love. Rejection = shame

Remember, social transition is a fully reversible change involving a change of pronoun, perhaps accompanied by a change of hair style, clothing, name. Nothing medical at all.

At its heart, a social transition is a clear message to a child that they are OK, that they are accepted, that they are not wrong or broken, that they are loved.

The Swedish study takes the view that there is a paucity of evidence, therefore children should not be supported to socially transition.

I agree that there is a paucity of rigorous long-term scientific studies on the outcomes for children who from an early age are supported and accepted.

What does exist is a whole heap of anecdotal evidence of the huge benefit of social transition. I personally know of over a hundred families for whom social transition has been transformational for their child’s happiness. Experts in Australia and America have found the same.

I have met scores of families whose only regret is that they did not embrace and support their child earlier. This includes our child. She was miserable every day – in acute distress. Since social transition she is one of the happiest children you can find. Loving school. Loving her friends. Having a wonderful childhood. Time and again from parents all over the world I hear the exact same story. A story that I hadn’t even heard before I lived it with my child.

From these very many happy socially transitioned children, I know of 2 cases where after a few years of social transition, the child has said to their parent, I want to try living as my assigned gender. In these small number of cases, a second social transition occurred that was no more difficult than the first social transition. At all stages a child needs to feel loved and accepted, that their family are listening to and respecting them. I know of a few more children who have grown into embracing a more nuanced or complex non-binary identity as they have got older (perhaps as they grow more aware of the existence of space between two binaries). Again – no known harm to those children whose understanding of their identity expands over time – as long as they are loved, cared for and accepted.

What is very well evidenced is the great harm that is caused when children are rejected, forced to live a lie, told that who they are is wrong or disturbed or shameful or unacceptable. The message trans girls learn quickly when their parents refuse to call them a girl.

Parents of transgender children know all too well that there is not enough useful research out there. We know that we have been deeply let down by past decades of research on transgender children that is not useful. Let down through the transphobia, homophobia, cis-het-normativity and or sheer incompetence of past researchers who failed to distinguish between trans and gender non-conforming children, and failed to explore which options would lead to the best outcomes for transgender children – including of course the option to affirm, love and accept them.

Much transphobic research continues in this vein. A few researchers, like Kristina Olson from the Trans Youth Project at the University of Washington, are now tracking the outcomes of socially transitioned, affirmed, supported children.

“withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including depression, anxiety and suicidality, social withdrawal”

The suggestion that ‘do nothing’ is even an option for parents of insistent, consistent, persistent transgender children is a mis-characterisation of life with a distressed child. As I describe in an earlier blog post

People say: “The best course of action would be for parents not to make any decisions at all”

This shows little understanding of what it is like to parent a transgender child.

Life is full of decisions.

Before making the extremely difficult and heart-breaking decision to support my child, for months I made the decision to say ‘I love you, but no, you are not a girl you are a boy’ and watched their sad face.

For months later, when they said ‘I am a girl’ I decided to change the subject or look away.

For months further I avoided directly calling them a boy but decided to sit in silence as others called them a boy and I watched their shoulders hunch in and the sad look of rejection on their face.

For months further I sat with them at bedtime as they cried and listened to them say ‘but I am a girl’ and I decided not to say ‘that is OK, we love you whatever’.

Life with a very insistent transgender child is full of difficult and painful and troubling decisions for a parent who cares deeply for their child.

Making a decision finally to say ‘that’s OK, we love you whatever’ was the latest in a very long line of decisions.

Which eventually moved on to ‘OK, we’ll call you a girl’, and ‘OK, we’ll help others to call you a girl’ and ‘OK, we’ll help others to understand you are a girl’.

We do not wake up one morning and think, wouldn’t it be fun to choose this incredibly hard and traumatic path for our children.

The above are my words from a couple of years ago. My perspective and understanding has shifted a great deal over the past few years and I no longer see being transgender as a negative or scary thing (though I dearly wish my child would not have to face a transphobic world or deal with prejudice and hate). But at the time I was ignorant and very afraid.

Parents do not consider supporting their child to socially transition on a whim. Take a look at the first 5 mins of this video in this link and see the experience of one American family.

Parents working up the courage to support their transgender child already have to overcome their own transphobia and ignorance (the vast majority of the cis parents I know knew nothing at all about trans children before our own child).

Parents working up the courage to support their transgender child already face extreme hostility from wider society. We already face social isolation and losing friends and family. It is not easy, even when a parent knows in their heart it is what their child needs.

Parents in this situation need ‘experts’ who understand what is at stake, who present all the facts and all recent research including the evidence in favour of social transition. We need experts who are willing to offer support and guidance to families and children for whom extended delay, extended rejection, extended denial of identity is cruelty to our transgender child.

To force children to live as their assigned gender, when doing so is causing them deep distress; to tell them to ‘wait until we have long term data’, when we know anecdotally how many children benefit from social transition, when we know zero evidence of harm, is gross negligence.

The ‘experts’ telling families to ‘wait until we have long term data on the outcomes for those socially transitioned children who we know are currently happy and thriving’ are telling parents to keep their child in a state of deep distress for no good reason. These ‘experts’ like this Swedish author have presumably not spent night after night holding a deeply distressed miserable child. They presumably have not watched their child shrink and lose all enjoyment of life. They also can’t have spent much time around children like mine who absolutely shine with happiness now that they have socially transitioned.

On one level, supporting a child to socially transition seems like the biggest, scariest, most inconceivable step in the world. And, at the time, for a family surrounded by a sceptical and transphobic community, it is.

But, on another level, it is just a change of pronoun. It is the smallest change in the world, and the biggest bargain out there. For this small change I got my happy child back. For this small change my child found love and acceptance instead of rejection and shame. For this small change my child got a carefree childhood full of games and play and friends and fun.

Scotland is currently holding a consultation on reforming their Gender Recognition Act. This proposes options to simplify the process for transgender people in Scotland to obtain full legal gender recognition (acquiring a Gender Recognition Certificate and amending their birth certificate).

This consultation seeks views on reforming the 2004 Act. The Scottish Government proposes to streamline the process for obtaining legal recognition and also to allow people aged 16 and over to apply. We are also seeking views about the options for people under 16 and for recognition of non-binary people.

The consultation provides key information on the Gender Recognition Act. It is critical to note however that even without a Gender Recognition Certificate, transgender people are legally protected under the 2010 Equality Act and have rights to change identity markers in systems including schools, the NHS and their passports, and have the right to use facilities matching gender identity. The Gender Recognition Act is however the only route to updating a birth certificate.

“GRC” – a gender recognition certificate. Under the 2004 Act, a full GRC provides legal recognition of an applicant’s acquired gender. When a GRC is issued under the 2004 Act, the applicant’s legal sex also changes to male or female. ”

“The 2004 Act allows transgender people aged 18 and over to apply for legal recognition of their acquired gender and to change their legal sex accordingly”

The consultation considers two main models for gender recognition, the current system of an assessment model (where a doctor, psychologist and or court ‘evidences’ a person’s gender identity) or a self-declaration model (as already applied in Norway, Denmark, Malta, Colombia, Argentina, and the Republic of Ireland).

For an example of how this is working in practice, this article provides a useful overview of how a self-declaration based process is already in action in the Republic of Ireland.

I won’t focus here on the proposed options for how the gender recognition system will operate, but will instead give attention to eligibility based on age – namely whether trans youth and trans children are permitted to get a Gender Recognition Certificate and change their birth certificate.

Under 18s.

At present in Scotland, as elsewhere in the UK, trans youth and trans children under 18 are not eligible for a Gender Recognition Certificate, meaning under 18s cannot update their birth certificate. Trans children and youth are however given legal protections under the 2010 Equality Act, and already have the right to change their gender marker in almost all other documentation, without the need for a Gender Recognition Certificate (including a right to change their gender marker in their passport, and in systems including schools and the NHS) (*as with adults options for identity recognition for trans youth/children with non-binary identities are extremely limited).

The consultation questions:

The survey starts with 4 questions for how GRC should work for adults including:

Question 1 The Scottish Government proposes to bring forward legislation to introduce a self-declaratory system for legal gender recognition instead. Do you agree or disagree with this proposal?

16-17 year olds.

The consultation proceeds to focus on 16-17 year olds:

“The Scottish Government considers that people aged 16 or older should be able to apply for legal recognition of their acquired gender using the proposed self-declaration process.

4.05. There is clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised. For example, the Women and Equalities Select Committee heard evidence from LGBT Youth Scotland to this effect. In the Republic of Ireland, 8 people aged 16 and 17 have received a GRC31 after obtaining a court order permitting them to apply under their self-declaration system. The court in the Republic of Ireland is required to consider evidence about the young person’s transition to their acquired gender. ”

Question 5 The Scottish Government proposes that people aged 16 and 17 should be able to apply for and obtain legal recognition of their acquired gender. Do you agree or disagree?

It is curious that the report notes the “clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised” and yet in subsequent sections does not similarly note the existence of transgender children under the age of 16. Parents of transgender children, and other groups supporting transgender young people were perhaps overlooked in the preparatory consultations? This oversight makes it especially important that parents and supporters of transgender children and young people provide feedback during this consultation that transgender children do indeed exist, and those under the age of 16 both want and need full legal recognition. Inputs from any under transgender young people themselves might also be an important addition to this consultation.

Under 16s

The consultation moves on to consider under 16s:

“4.08. The Scottish Government’s view is that there is a careful balance to be struck in relation to people under 16. On the one hand, we should treat children with dignity and respect, giving weight to their views and wishes in line with their individual capacity. On the other hand, we should ensure that children have the right protection and care. 4.09. People who are under 16 years of age can act on their own behalf in relation to a range of matters. Annex E contains further information about this. The CRWIA at Annex M refers to research evidence about children who identify as transgender. 4.10. The Scottish Government considers that there are five broad options in relation to people under 16 being able to apply for legal gender recognition.”

The consultation proceeds to outline 5 potential options for transgender children under the age of 16. I’ve quoted these here in full, following which I’ve outlined my thoughts on each option:

Under 16s – option 1 – nothing for those under 16

4.11. Under this option, applicants would have to be at least 16 to apply for legal recognition of their acquired gender. This would be straightforward, but would stop those under 16 with a clear view of their gender identity from obtaining legal gender recognition.

Under 16s – option 2 – court process

4.12. Option 2 would be for Scotland to adopt a court based process.

4.14. Any court based process, whether instigated by a child’s parents or by the child themself, would focus on the assessment of the child’s welfare. We would also consider specifying the matters the court would have to have regard to in determining what was in the child’s best interests. 4.15. Under this option, a court action could be raised by the child if they had sufficient capacity to do so, or if they did not, by a person or persons who had PRRs (parental responsibilities and rights) for them acting on their behalf.

4.19. Malta has a court based process of legal gender recognition for those under 18. Those with parental authority for a child may file an application in the court. The court must consider the best interests of the child and give due weight to the views of the child depending on their age and maturity

4.20. In the Republic of Ireland, applications cannot be made by those aged under 16. However, applications by 16 and 17 year olds require to be accompanied by a court order permitting the application to be made. The court may only grant the order if the child’s parents, surviving parent or guardian consents. Two medical certificates must also be produced to the court. The medical certificates must confirm that: · the child has a sufficient degree of maturity to decide to apply for gender recognition; · the child is aware of, has considered and fully understands, the consequences of that decision; · the child’s decision is freely and independently made; and · the child has transitioned, or is transitioning to, their preferred gender.

4.21. Under option 2, a child who may not have reached puberty might apply to the court or a person with PRRs for such a child might apply.

Under 16s – option 3 – parental application

4.22. Option 3 would be to permit an application to be made on behalf of a person under 16 by someone with PRRs (parental responsibilities and rights) for them. Typically, this would be the child’s parents. Further information about PRRs, when parents get them and who else may have PRRs is in Annex F. 4.23. Usually, where more than one person has parental rights in relation to a child, each can exercise their rights without the consent of the other or any of the others.36 4.24. Where a person with PRRs is reaching a major decision regarding the fulfilling or exercise of PRRs, the person is under a duty to have regard to any views the child expresses, taking account of the child’s age and maturity. The person making the decision must also have regard to any views expressed by any other person with PRRs for the child concerned.37 The Scottish Government considers that seeking legal recognition in an acquired gender is an example of a major decision. 4.25. One possibility under this option would be to require the application to be made by all parents with PRRs for a child. This would mean that a person who had PRRs for the child but was not their parent would not require to be involved. However, we would still expect the person(s) applying on the child’s behalf to have regard to the views of such a person. 4.26. Another possibility under this option would be to require all people with PRRs to apply, not just a parent or parents with PRRs. This may mean that a local authority that had PRRs for a child would need to be involved in the application process. 4.27. If all the people who required to be involved in the application did not agree38, then a court order could be sought under existing arrangements. Section 11(1) of the Children (Scotland) Act 1995 allows the Sheriff Court or the Court of Session to make an order in relation to PRRs. The court could then make a decision based on the child’s welfare. 4.28. There are some children for whom no one has PRRs. One option might be for a person who has an interest to obtain PRRs from the court and then apply for legal gender recognition on behalf of the child.

4.30. In summary, therefore, under this option all parents with PRRs (or, perhaps, everybody with PRRs) would have to apply, having had regard to the child’s views. If there is a dispute amongst those with PRRs, an application could be made to the court to resolve the matter. There may be restrictions on the role of a person with limited PRRs. 4.31. Under this option, applications could be made on behalf of very young children, including both those who lack legal capacity and who have not reached puberty.

Under 16s – option 4 – minimum age of 12

4.32. Option 4 would permit children aged 12 and above to apply in the same way as those aged 16 or above

4.34. However, this option would take no account of a child’s capacity to take decisions nor their physical maturity.

4.36. The Scottish Government does not favour this option as it would allow a child to apply irrespective of their capacity to understand the nature and consequences of their decision.

Under 16s – option 5 – application by capable child

4.37. Option 5 would permit a person under 16 to apply in the same manner as an adult, provided they had capacity to understand the consequences of recognition in their acquired gender.

4.38. Under this option, someone would have to test the child’s capacity. This could potentially be done, for example, by a registered medical practitioner, or by a practising solicitor.

4.40. A person under 16 has legal capacity to instruct a solicitor, in connection with any civil matter, where the person has a general understanding of what it means to do so. Someone aged 12 or more is presumed to be old and mature enough to have such understanding.

The section ends with question number 6, which asks consultation respondents to state which of the 5 potential options for transgender children under 16 they most favour.

Question 6

Which of the identified options for children under 16 do you most favour? Please select only one answer.

option 1 – nothing for those under 16

option 2 – court process

option 3 – parental application

option 4 – minimum age of 12

option 5 – application by capable child

My response to the consultation

My initial thoughts to the above is as follows:

Option 1 – nothing for under 16s, is unacceptable. Many of our trans children are living as their identified gender from primary school, including changing their gender marker in other systems including on their passport. Why then should they have to wait until 16 to have who they are fully recognised in law? When they have been living for years with a passport and other markers in their gender identity, why should their birth certificate be out of sync? Inability to update birth certificate adds to stress for trans children that their identity will be unwillingly disclosed and presents to them the reality that the state does not fully respect them until adulthood. Trans children exist, and waiting until 16 or 18 for proper legal recognition is denial of basic rights for these young citizens.

Denying rights to under 16s is at odds with the recent WPATH (World Professional Association for Transgender Health) statement on identity:

“WPATH advocates that appropriate gender recognition should be available to transgender youth, including those who are under the age of majority,”

Option 2 – court process seems like an expensive, bureaucratic, stressful and unneccessary requirement. I would like to learn more from Ireland, who has a similar requirement for 16-17 year olds which is currently under review. Australia, which has just got rid of a requirement for trans youth to go to court for hormone treatment, provides a useful case study of this process.

CASE STUDY: Australian experience of a court based process

Australia until very recently required under 16s to go to court to gain approval for gender related medical care. Families and transgender children in Australia found the process of going to court stressful and upsetting. When one family were told that the requirement to go to court was being removed, one family reportedly “were unable to contain their tears of relief” with their child commenting “No longer will young transgender young people have to keep justifying who they were“.

World leading specialist in supporting transgender children, Dr Telfer, Director of the Gender Service at the Royal Children’s Hospital in Melbourne described the amount of time gender specialists were having to devote to guiding families through the court proceedings:

“Gender Clinic staff have had to spend considerable time on counselling families on what the court process would be like, Dr Telfer said.

“No-one wants to be in a courtroom. Usually it’s a place where you go when something is wrong.

The requirement for transgender youth to go to court was described as “costly, traumatic and unnecessary”.

The director of legal advocacy at the Human Rights Law Centre, Anna Brown, described the decision to stop forcing transgender children in Australia to go to court as a “stunning victory” for young transgender people.

“This will make a profound difference to the lives of many young trans people who will now be relieved of the burden of a costly and unnecessary court process”

“This bizarre legal anomaly was born of outdated attitudes to trans young people”

“Importantly, also, for the young people themselves, going to court can be hugely taxing,”

“This decision is a huge victory for so many young people and their families. The latest research shows that there are probably around 45,000 trans and gender-diverse young people in Australia, and this will save them enormous amounts of money, time and heartache.”

Australia has made the decision to move away from requiring transgender children to go to court. Why then would Scotland wish to impose this on Scottish trans children? Based upon the Australian experience, the Option 2 court process, is not the right decision for our children.

Option 3 – parental application seems instinctively a sensible option. With parental approval children like my daughter could get their identities fully legally recognised. This would however limit options for youth who do not have parental support, and such youth would either need to wait until 16 or would need to have recourse to an alternative option eg to the court option. I wonder whether there are many youth without any parental support for whom gaining a GRC pre 16 would be a major priority? I’d welcome feedback from trans youth or organisations working with trans youth.

Option 4 – minimum age of 12 is largely ruled out by the Scottish consultation, and I would agree that basing declaration on age, rather than capacity for decision-making, would be unworkable.

Option 5 – application by capable child is attractive in theory but I question how it would work in practice. It would require an administration layer including professional gate keepers, requiring our children to submit to an assessment, and I wonder who would be willing to test a child’s capacity for this purpose. This might result in a very small number of medicalised gate-keepers and subject to waiting lists, delays and arbitrary protocols. There’s also a very serious question about how to ensure such professional are able to assess a child’s capacity in a sensitive and appropriate manner – those of us with trans children are well aware of the level of transphobia and ignorance about trans children so common across the UK.

Seeking another opinion

“We’re currently in favour of Option 3 – the ‘parental application‘ option – where under 16s would be allowed to change gender on birth certificate on submission of a simple statutory declaration with signed parental consent. This would mirror how name changes on official documents are already done for under 16s.

We think that if a young trans person under 16 has unsupportive parents then the most urgent problems they will be facing are likely to be whether they are safe from transphobic emotional abuse at home and whether they are able to wear clothes they want and use the verbal pronouns they want. We think that it is rare that a child under 16 with unsupportive parents will be in a confident and safe enough position to risk trying to change their birth certificate against the wishes of their parents.

We think that nearly all under 16s who have been able to successfully start living fully in their gender identity (and therefore are at the point where it would make sense to change their birth certificate to improve their privacy) will have at least one supportive parent. However, it is important that there is a way of ensuring that an unsupportive parent is not able to block the wishes of the young person and their supportive parent. If a court process is needed to resolve a family dispute about whether a young person should be granted a GRC, then we think the court ought to be obliged to uphold the wishes of the young person provided they have capacity to understand the consequences of legal gender recognition.

While Option 5 – the ‘application by capable child’ option – sounds on the surface like a more empowering option than parental application, we have concerns that it may lead to problematic gatekeeping by doctors/solicitors who could be scared to approve the capacity of individual trans young people. It could result in say a 13 year old with supportive parents having to try to prove their capacity to a trans-ignorant doctor only to be told they are too young to understand the consequences and that they have to wait as their parent can’t give consent on their behalf. That could be a very stressful and disempowering experience.

Not allowing under 16s to change the gender on their birth certificate leaves them at risk of schools not taking their gender identity and right to privacy of their gender history seriously. Under 16s usually don’t have bank accounts or many letters sent to them so proving their identity without showing a birth certificate is harder for under 16s than for trans adults. This means trans people under 16 are at greater risk than adults of privacy violation, and transphobic harassment as a result, due to their birth certificate outing them as trans. The intensity of media hostility and resulting negative social attitudes towards trans youth and their families makes privacy rights particularly essential.

Changing birth certificate would have no impact on ability to access hormone blockers but could make a life enhancing difference to moving to a new school without being outed.

It’s worth noting that parents of trans young people under 16 can already change their child’s gender on their passport and medical records so it makes sense to bring birth certificates into alignment with these other official documents.”

Preferred option

Having reviewed the proposed options, and consulted with other stakeholders, the best option for under 16s seems to be Option 3 – parental application.

Flawed research evidence underpinning the consultation

Before concluding, I would also like to share my views on the annexes to the consultation which contain some worryingly flawed ‘evidence’ that if accepted as presented could seriously undermine trans children’s rights.

The Scottish consultation document presents ‘research evidence’ on transgender children in annex M part 4.

ANNEX M: PARTIAL CHILD RIGHTS AND WELLBEING IMPACT ASSESSMENT

What research evidence is available?

4.1 There is evidence that children can experience incongruence between their assigned gender and their gender identity early in life. One study indicates the average age was 8.

4.2 There is a limited evidence base about whether children will continue to experience these feelings in the longer term. Follow-up studies indicate overall that for 85.2% of the children, their distress discontinued either before or early in puberty. 8 However, the rates in the individual studies varied widely. For instance, a 2008 study indicated that in 39% of children the feelings did continue beyond the onset of puberty9 whereas older studies from before 2000 had very much lower rates for children continuing to experience distress after the onset of puberty. It is thought that pre-2000 studies have included children who would not now be considered to be experiencing gender dysphoria. The studies may also be affected by the small clinical population of children with gender dysphoria – studies looking at whether gender dysphoric feelings persisted had a total population of 317 people.

Part 4.2 in particular misrepresents the current body of evidence and is danger of undermining the Scottish consultation through establishing a prejudicial approach to children gaining legal recognition.

Wallien and Cohen-Kettenis “Psychosexual outcome of gender-dysphoric children” Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1413–1423

We have previously addressed and demonstrated the lack of credibility of these exact studies here.

Conversely, new evidence, that has not been presented in the consultation Annex, suggests a very significantly higher rate of transgender children continuing to identify as transgender as adults and has been reviewed by us here.

4.3 There is also evidence that the more extreme a child’s gender dysphoria was before puberty, the less likely it was that their feelings will recede with the onset of puberty. For those who have reached puberty and continue to experience distress, evidence indicates that their distress then tends to intensify and that depression or self-harming behaviours are also more common in ages 12 and over. It is understood that physical changes caused by puberty may intensify the levels of distress experienced.

4.4 Available evidence suggests that factors arising around the ages of 10 to 13 may help explain changes in how a child feels about their gender: · the changes in social roles between boys and girls as their gender role become more distinct; · the anticipation or experience of physical changes as a result of puberty; and · their first experience of experiencing falling in love and discovering their sexual identity.

4.5. Evidence indicates that there is a difference of experience between boys and girls. 13 Although more boys are referred to gender identity clinics, some studies suggest that gender dysphoria is more prominent in girls.

Part 4.4 relies on one specific flawed study that absolutely does not evidence the claim presented here.

There is no evidence in this single referenced study that a transgender child changes identity between the ages of 10 and 13 as misrepresented here. This is grossly misleading and risks undermining support for trans children in Scotland gaining legal recognition. We have previously discussed the flaws of this specific paper in some detail here.

4.6 There is evidence that transgender young people are more than twice as likely as non-trans people to be diagnosed with depression (50.6% compared to 20.6%14) and with anxiety (26.7% compared to 10%). There is evidence that this most likely arises due to their experience of discrimination, lack of acceptance, and the abuse they may face and is not an inherent feature of their being transgender. 15 There is also evidence that transition to living in their preferred gender and being supported with gender confirming medical interventions may help improve mental health, in many cases reaching levels experienced in the general population.

It is clear that discrimination and lack of acceptance is damaging to trans youth. The government has a responsibility to tackle this, including through enabling trans children like my daughter to gain full legal recognition. Not allowing full legal recognition to children also sends out a damaging signal to those children and to wider society that transgender children are not worthy of respect or rights.

4.7 Scottish Government officials met members of LGBT Youth Scotland groups aged 13 and over. Their view was that legal gender recognition must be made available to people younger than 16. A person should be able to transition and live in their acquired gender before they have to take their qualifications or go to university. They felt that this would better support their rights not to be discriminated against, for example, at school. A high proportion expressed the desire for their parents (or other people with responsibility for them) to be involved and supporting them through the recognition process.

4.8 LGBT Youth Scotland gave evidence to the Women and Equality Select Committee inquiry into Transgender Equality which setting out the views of transgender people aged under 1817 about the benefits of legal gender recognition in terms of reducing discrimination and improving their mental health.

There is a concerted effort in the UK, as elsewhere, to deny transgender people basic human rights. This campaign is particularly targeting transgender children, the most vulnerable of transgender people, and those with the least power and voice. It is critical that this consultation focuses on listening to transgender children and to those families who support them. Trans children are a small and very marginalised group, and their voices must not get lost in the wider consultation. It is not acceptable to tell transgender children that they have to wait until they are adults before they can be recognised in law.

Appendix A TRANSGENDER CHILDREN – EVIDENCE OF NUMBERS EXPERIENCING GENDER DYSPHORIA OR DISCOMFORT WITH THEIR ASSIGNED GENDER

Appendix A presents a confused view of the difference between transgender children, and children who are gender non-conforming. It alarmingly includes reference to studies from the discredited Zucker, and makes multiple references to “opposite sex behaviour”. It is worrying that a public consultation on gender recognition should have included such a muddled understanding.

Conclusion

Transgender children are one of the most marginalised, voiceless and powerless groups in society. I encourage all who care for transgender children to complete this consultation, and for question 6 I recommend selecting Option C – parental application.

Additionally, in the accompanying comments box for the consultation it would be useful to mention some basic facts:

a) transgender children exist

b) transgender children have legal rights and need legal recognition

c) transgender children face enough challenges, discrimination and hostility already – legal recognition should not be an additional burden for them

The consultation documents mention the “clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised” and yet are silent on on the existence of transgender children or their desire and need for full legal recognition under the age of 16 year.

This right, if enabled, would not be pursued by every transgender child. Parents would not take this option on a whim. This option would be most appropriate for transgender children who have already been living in their identified gender for many years, who likely already have all other identity documents including their passport updated to their identified gender. To deny these children full legal recognition until 16 is a gross betrayal of their rights.

Yet transgender children are one of the least powerful and most marginalised groups in our society. We know that transphobic groups are actively campaigning against the provision of rights to transgender children. The needs and the voices of transgender children may not be heard in this consultation.

It is vital that families of transgender children feed in to this consultation, including those outside of Scotland, making it clear that transgender children do indeed exist and do deserve full legal recognition. Inputs from transgender adults and allies who care for transgender children will also be critical, as supportive families of transgender children are already overwhelmed with the barriers we have to overcome to enable our children to get the rights and the protections that other children take for granted.

Input from any transgender children and young people who are willing to share their thoughts and words would be especially valuable, perhaps explaining what an updated birth certificate would mean to them, or how they feel about being denied the right to full legal recognition.

Read on for new (as yet unpublished) ‘desistance’ statistics from Australia (Spoiler: it may be as low as 4% ‘desistance’).

The 85% ‘desistance’ myth

Anyone with even a cursory awareness of issues relating to transgender children will have heard the 85% ‘desistance’ myth. Some old and flawed research studies, that lumped together large numbers of gender non-conforming cisgender children with transgender children, claimed astonishingly high levels of supposed ‘desistance’, ie children who held a cisgender (not transgender) identity after puberty. These studies are flawed in many ways, including in their analysis, where they assumed that children who could not be contacted or declined to be interviewed were all so called ‘desisters’. These statistics often relied upon older data from the 1970s and 1980s, a period in which societal acceptance for transgender people in the West was a long way behind where it is today. The 85% ‘desistance’ myth has been widely criticised:

Nevertheless, it is difficult to get rid of an old statistic, no matter how discredited, when there is not a better one available. Hence many of us have been eagerly awaiting new figures from the United States, where longitudinal research on a cohort of transgender children is currently underway.

The myth that will not desist

Despite the clear evidence and analysis that the research studies underpinning the 85% ‘desistance’ statistic are deeply flawed and unreliable, academic paper after academic paper on transgender issues continues to repeat this old discredited 85% figure. It is easier to present the mistakes of the past than to engage in this topic, especially where the research is not specifically focused upon gender dysphoria in children, and where the author is required to discuss persistence only as part of a wider survey of the literature. However discredited the 85% ‘desistance’ figure is, it keeps getting published as there is not (until now), a better ‘desistance’ statistic to put in its place.

Endocrine society continues the myth

The 2017 Endocrine Society guidelines still refer to the 85% figure, though they do at least note that non-conforming children may be included in those older studies and acknowledge that persistence rates may well be different in future studies.

“However, the large majority (about 85%) of prepubertal children with a childhood diagnosis did not remain GD/ gender incongruent in adolescence (Source: Steensma TD, Kreukels BP, de Vries AL, Cohen-Kettenis PT. Gender identity development in adolescence. Horm Behav. 2013; 64(2):288–297.”

“Prospective follow-up studies show that childhood GD/gender incongruence does not invariably persist into adolescence and adulthood (so-called “desisters”). In adolescence, a significant number of these desisters identify as homosexual or bisexual. It may be that children who only showed some gender nonconforming characteristics have been included in the follow-up studies, because the DSM-IV text revision criteria for a diagnosis were rather broad. However, the persistence of GD/gender incongruence into adolescence is more likely if it had been extreme in childhood (41, 42). With the newer, stricter criteria of the DSM-5 (Table 2), persistence rates may well be different in future studies.”

The above paragraph is disappointing from the Endocrine Society. If a statistic is known to be useless then it is better to have no statistic at all than a wrong one.

“the 84 percent desistance figure is meaningless, since both the numerator and denominator are unknown, because you have no idea how many of the kids ended up transitioning (numerator), and no idea how many of them were actually gender dysphoric to begin with (denominator).

Scottish Gender Recognition Act (GRA) Consultation

The newly released Scottish Gender Recognition Act consultation has taken an even more disappointing approach than the Endocrine Society – they do not make it clear that the 85% ‘desistance’ rate is widely discredited and they combine it with other statements about gender changes at around puberty that are based on fundamentally flawed research (see below).

4.1 There is evidence that children can experience incongruence between their assigned gender and their gender identity early in life. One study indicates the average age was 8.

4.2 There is a limited evidence base about whether children will continue to experience these feelings in the longer term. Follow-up studies indicate overall that for 85.2% of the children, their distress discontinued either before or early in puberty.

However, the rates in the individual studies varied widely. For instance, a 2008 study indicated that in 39% of children the feelings did continue beyond the onset of puberty whereas older studies from before 2000 had very much lower rates for children continuing to experience distress after the onset of puberty. It is thought that pre-2000 studies have included children who would not now be considered to be experiencing gender dysphoria. The studies may also be affected by the small clinical population of children with gender dysphoria – studies looking at whether gender dysphoric feelings persisted had a total population of 317 people.

4.3 There is also evidence that the more extreme a child’s gender dysphoria was before puberty, the less likely it was that their feelings will recede with the onset of puberty. For those who have reached puberty and continue to experience distress, evidence indicates that their distress then tends to intensify and that depression or self-harming behaviours are also more common in ages 12 and over. It is understood that physical changes caused by puberty may intensify the levels of distress experienced.

4.4 Available evidence suggests that factors arising around the ages of 10 to 13 may help explain changes in how a child feels about their gender: · the changes in social roles between boys and girls as their gender role become more distinct; · the anticipation or experience of physical changes as a result of puberty; and · their first experience of experiencing falling in love and discovering their sexual identity. “

Point 4.4 also refers solely to another Steensma study (2010) that we demonstrate to have multiple flaws. The ‘evidence’ is outrageously weak and fundamentally unreliable, and should not have been quoted in the Scottish GRA consultation document.

This false information forms a key part of the information upon which Scottish stakeholders are to make decisions on the appropriateness of rights to legal identity recognition for under 16s. Stating 85% ‘desistance’ has the risk of influencing Scottish stakeholders away from supporting the rights of transgender children and adolescents.

The UK NHS Children’s Gender Identity Service continues the myth

Dogged adherence to the discredited 85% ‘desistance’ figure on the behalf of the UK Children’s Gender Identity Service continues to have serious and damaging effects on transgender children in the UK. A recent publication (Costa 2016) by two experts at the UK Gender Service, makes it clear that belief in this flawed ‘desistance’ rate is the key factor underpinning their insistence on a ‘watchful waiting’ (also known as delayed transition) approach.

“Treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults”

“The percentage of children initially diagnosed with gender dysphoria who display persistence of the condition ranges from 12–27%, indicating that the majority of children meeting gender dysphoria criteria do not have persistence of the condition by the time they have entered puberty.”

“Most importantly, this approach is based on the evidence is that only a minority of those with untreated childhood gender dysphoria will identify as transsexual or transgender in adulthood, while the majority will become comfortable with their natal gender over time”

“A second approach considers it crucial not to interfere with the child’s development. ….the basis of this strategy is the absence of clear-cut predictors of gender dysphoria persistence in adulthood and the evidence that a substantial percentage of gender-variant behaviour in childhood will not culminate in adult gender dysphoria”

The service continue to quote this statistic to parents of insistent, consistent and persistent transgender children, telling them that their specific children will almost certainly shift to a cisgender identity at puberty – statements that have the risk of discouraging parents from listening to, accepting and loving their child.

Many of us have been hopefully looking to the United States for some better figures on ‘desistance’. But as we have looked West, some new figures have emerged from Australia.

November 2017 game changer: landmark Australian court case on transgender rights

A recent landmark court case in Australia described as “the greatest advancement in transgender rights for children and adolescents in Australia”, successfully removed a requirement for court approval for the prescription of cross sex hormones for gender dysphoric adolescents.

As part of the multiple court proceedings for that case, a “battery of reports from experts” were commissioned by the court. Dr Michelle Telfer, a world leading specialist in transgender children’s health, of the Royal Children’s Hospital in Melbourne (and one of the authors of the new Australian Guidelines) was one of the key expert witnesses called to produce evidence from the Australian Gender Service. This evidence is summarised in the publicly available court report for the case titled ‘Re: Kelvin’ that was released this week:

FAMILY COURT OF AUSTRALIA RE: KELVIN

“The fifth intervenor, the Royal Children’s Hospital Gender Service in Victoria is a specialist unit comprising of a team from multiple disciplines including Paediatrics, Psychiatry, Psychology, Endocrinology, Gynaecology, Nursing and Speech Pathology. Since its commencement in 2003, the Gender Service has received 710 patient referrals including 126 between 1 January 2017 and 7 August 2017. 56. 96 per cent of all patients who were assessed and received a diagnosis of Gender Dysphoria by the 5th intervenor from 2003 to 2017 continued to identify as transgender or gender diverse into late adolescence. No patient who had commenced stage 2 treatment had sought to transition back to their birth assigned sex. No longitudinal study is yet available.” <page 8 points 55 and 56>

“Senior counsel continued: In addition, we have evidence from Dr Telfer which has made its way into the case stated at paragraph [55] about the experience of the gender service of the Royal Children’s Hospital over a period from 2003 to 2017, which also encompasses, therefore, new medical knowledge and, in particular, at paragraph [56] Dr Telfer’s affidavit – I’m sorry the case stated, picking up from Dr Telfer’s affidavit, the case stated records as a fact that 96 per cent of patients treated for gender dysphoria at the Royal Children’s Hospital continue to identify as transgender into late adolescence and so one sees some evidence there about persistence of gender dysphoria. Again, we would say that data is new. (Transcript, 21 September 2017, p 66, l 37 – 45)” <page 33 point 160>

Let’s focus on the the critical line:

“From 2003 to 2017 96 percent of all patients assessed and diagnosed with Gender Dysphoria continued to identify as transgender or gender diverse into late adolescence”.

This evidence is stating is a 96 percent ‘persistence’ rate into late adolescence. This implies a 4% ‘desistance’ rate. This may mean that only 4 percent of children diagnosed with Gender Dysphoria might shift to a cisgender (not transgender) identity. This represents a wildly divergent statistic than the 85% ‘desistance’ myth, and much closer to the anecdotal findings of those who have experience parenting, working with and supporting transgender children.

“As the mother of a young trans daughter who has spent the past six years interacting with hundreds of families with kids like mine, the notion that detransition is rare strikes me as a statement of the obvious. In fact, the “80 percent of these kids change their minds” statistic feels a lot like Trump’s inauguration crowd size claims. If 80 percent of these kids are really desisting, where the hell are they? You’re telling me they’re there, but I’m just not seeing them. I’ve actually never met one.”

What would a 4% ‘desistance’ mean in practice?

The Australia statistic refers to persistence “until late adolescence” (they can’t yet have longer term data – and we will have to wait until this cohort of young people grow into middle age). However, given that even many of the flawed studies on ‘desistance’ acknowledge that those who are transgender at late adolescence will almost all persist through adulthood this provisional 4% ‘desistance’ figure should cautiously be taken as an important data point.

This has potentially huge implications for policy. For how our society listens to, respects and supports transgender children. For how the media portray transgender children. For how specialists, including the UK Children’s GIDS talk to parents about transgender children. Remember the UK NHS website still looks to the outdated, flawed research and says:

“Across all studies approximately 16% continue with their gender identification”

It is time to put the 85% ‘desistance’ myth in the bin where it belongs.

The Australian 4% ‘desistance’ figure has not yet been formally published, and until we have peer reviewed analysis they should be treated cautiously. It is however derived from data collected from the 710 individuals who have been seen from the inception of the Melbourne gender service in 2003 and has been provided as evidence in legal proceedings. It should be treated as the most representative data point we have to date for likely outcomes of gender dysphoric children.

While we await data from the longitudinal studies being led by Kristina Olsen and others in the United States, let us discard the 85% desistence figure that is known to be junk science. We know how much damage the 85% ‘desistance’ figure causes. Let’s call an end to this harm.

Let’s start with the upcoming UK Gender Recognition Act consultation.

To the Women and Equalities Select Committee, to the Secretary of State for Equality, and to all engaged in planning the UK GRA consultation document: – do not repeat the failings of the Scottish consultation document – do not use the discredited ‘desistance’ figure that is not only unreliable, but is shown by this new Australia data to be grossly inaccurate and misleading.

To stakeholders in Scotland: It is not acceptable that the consultation documents include this junk 85% ‘desistance’ statistic, without fair acknowledgement that it is widely discredited. If the real ‘desistance’ figure in the UK is even remotely close to the 4% ‘desistance’ provisionally found in Australia, the 85% figure is not just junk science, it is grossly misleading and actively harmful. It is not hard to see that ill-informed stakeholders across Scotland are much less likely to support the rights of transgender under 16 if they are told that 85% will shift to a cisgender identity. If those same stakeholders had been told that the latest findings demonstrate only as few as 4% of transgender children may later shift to a cisgender identity, it is feasible the consultation would come up with very different results. It is incumbent upon those in Scotland to make up for this disgraceful error, and make sure the rights of transgender under 16s are respected in the forthcoming revised Scottish GRA.

To Michelle Telfer and colleagues from the Australian Gender Service: thank you for providing this data and for providing evidence based advocacy on behalf of transgender children. The 85% ‘desistance’ myth causes so much damage in so many spheres. Please can you publish your data, even in its raw form, within a peer reviewed journal. Please give more information on the sample size, how many were pre and post adolescence, the ages of your sample group; It is crucial to ensure the 85% ‘desistance’ myth is not repeated in WPATH Standards of Care 8, dooming another generation of transgender children to disbelief, delay and denial of care.

To Gail Knudson and Board Members of WPATH: Please consider how you can ensure WPATH SOC 8 does not continue to perpetuate discredited statistics like the 85% ‘desistance’ myth. This causes real harm. Where evidence is flawed it must be discarded. To include statistics that are unreliable, and that in light of initial findings from Australia, may be wildly incorrect, is unethical and causes extensive harm.

To the UK NHS Tavistock Children GIDS. Please adapt and learn from the example of Australia where a specialist from the Australian children’s gender identity service is advocating, including in court proceedings, for the rights of transgender children.

Please consider publishing the data that has been collected. We need more information and analysis on how the UK figures compare to Australia and other children’s gender identity services worldwide. Publish your data.

To parents of transgender pre-pubertal children who have been repeatedly told that your specific insistent, consistent, persistent transgender child will almost certainly shift to a cisgender identity at puberty, despite the clear lack of examples of this happening with any enormous frequency. Now is the time to listen to your children. Now is the time to demand better from those who are meant to care for and support them.

Post script: Risks of not providing treatment

Failure to provide gender affirming hormones results in the development of irreversible physical changes of one’s biological sex during puberty or the development of changes that lead to the need for otherwise avoidable surgical intervention such as chest reconstruction in transgender males or facial feminisation surgery in transgender females.

The prolonged use of puberty blockers (stage 1 treatment) has long term complications for bone density (osteopenia) namely osteoporosis and bone fractures in adulthood. Best practice is to limit the time an adolescent is on puberty blockers and then commence oestrogen or testosterone. Delaying stage 2 treatment for those on puberty blockers also results in psychological and social complications of going through secondary school in a pre-pubertal state which is inconsistent with the child’s peers. [2017] FamCAFC 258 Reasons Page 5

The distress caused by Gender Dysphoria can lead to anxiety, depression, selfharm and attempted suicide.

Individuals with Gender Dysphoria who commence cross sex hormone therapy generally report improvements in psychological wellbeing. An affirmation of their gender identity coupled with improvements in mood and anxiety levels typically results in improved social outcomes in both personal and work lives.

For a transgender male, manifestations of increased body hair and deepening of the voice are generally considered by them as positive.

For transgender females if stage 2 treatment is not administered another risk is linear growth beyond their expected final height.

Some patients receiving treatment for Gender Dysphoria have reported purchasing hormones over the internet or illegally obtaining hormones through prescriptions written for other people. They have also reported that oestrogen and testosterone are cheap and freely available over the internet or through friends or acquaintances. Accessing hormones in this way is dangerous for several reasons including the risks of complications from blood borne viruses such as Hepatitis B, Hepatitis C and HIV contractible with shared use of needles and syringes and the taking of inappropriate dosages of hormones which can be life threatening.